Perceptions of Patient Engagement Applications During Pregnancy: A Qualitative Assessment of the Patient’s Perspective

Abstract

BackgroundWith growing demand for medical information and health applications in pregnancy, the potential of electronic health (eHealth) and mobile health (mHealth) solutions in clinical care is increasingly unfolding. However, we still do not know how pregnant women engage with mobile apps, how such apps impact routine medical care, and whether benefit expectations are met. Whereas recent research has raised the subject of user distribution and analyzed the content of pregnancy applications, there is still a significant knowledge gap regarding what pregnant women like and dislike about pregnancy tools, along with how such interventions could be improved.ObjectiveThe aim of the study was to examine the perceptions and expectations of mobile and Web-based patient-engagement pregnancy applications. We assessed usability requirements, general acceptance of eHealth, and the impact of eHealth and mHealth pregnancy applications on the doctor-patient interaction and daily clinical routine.MethodsA qualitative study was conducted at the maternity department of a major German university hospital. The sample included 30 women with low- to medium-risk pregnancies. Half of the patients were seen during outpatient care and half were hospitalized for several days. The extent and frequency of Web- and mobile phone app usage were assessed. Semistructured interviews were conducted and analyzed using systematic thematic analysis.ResultsPatients had a high demand for Web-based pregnancy applications. Study findings suggested a strong request for personalization, monitoring, and accessibility for frequent use as main themes derived from the interviews. Fostering patient empowerment in the doctor-patient relationship was also highly valued for a pregnancy app. Participants favored further integration of medical apps in their daily routine and pregnancy care. However, concerns were raised about content quality, trustworthiness of Web sources, and individual data security.ConclusionseHealth and mHealth applications are a highly frequented source of information. Expectations and usability requirements for those applications are also high, thus posing a challenge to interdisciplinary service providers. Patients’ attitude toward integrating apps in routine care settings was positive with a favorable influence on patient empowerment. Health care professionals should guide pregnant women toward a successful integration of these educational tools in pregnancy care.

‘It Just Gives Me a Bit of Peace of Mind’: Australian Women’s Use of Digital Media for Pregnancy and Early Motherhood

“…Hundreds of smartphone apps are available to provide advice and information about pregnancy and parenting. Studies have found that pregnant women and mothers in the global North are beginning to use apps in significant numbers [10][11][12][13]. Many of these provide functions that encourage women to monitor and survey their own bodies and those of their children, thereby entering very personal details.…”

The Rise of Pregnancy Apps and the Implications for Culturally and Linguistically Diverse Women: Narrative Review (Preprint)

“…It is also suggested that health professionals guide women in their use of mhealth tools during pregnancy [18] and that professionally endorsed apps be used adjunctively by health professionals as part of their maternity health care protocol [55]. Further, to ensure the accessibility and uptake of reliable app-based pregnancy information, the provision of free hospital-endorsed apps with complementary resources, such as supportive training and education to use them [12], are recommended.…”

“…One US study found Google searches were the most common mode of information seeking, particularly early in pregnancy [16]. An important factor for many women was the ability to obtain information instantly and easily [6,15,17,18]. Importantly, in one global study almost half of the 613 women surveyed reported that their online information-seeking was triggered by dissatisfaction with health professionals regarding both the information provided and insufficient time to ask questions.…”

“…Women also value pregnancy apps and digital platforms "that are multifunctional and interact with each other" [6]. Participants in a recent German study strongly advocated for apps that had the functionality to provide individualized feedback, "communication platforms" for pregnant women and medical professionals, and indicated a desire for the integration of apps into clinical routine and pregnancy care [18]. Pregnant women interviewed to inform the design of a Dutch pregnancy app wanted all of the above-mentioned features, as well as: a push notification system to remind them of tasks they needed to accomplish; an alert system to tell them if any monitored signs became irregular or dangerous; and a social media module for connecting with other pregnant women [21].…”

“…Patients may also be wary of the reliability of pregnancy apps or other ehealth content and have demonstrated concerns about personal data security [18]. A 2013 Australian study found that while the Internet was the first-used source of information by most pregnant women, it was the least trusted [13].…”