Quality of life among pregnant women with urinary incontinence: A cross-sectional study in a Malaysian primary care clinic

Jaffar, Aida; Sidik, Sherina Mohd; Manaf, Rosliza Abdul; Foo, Chai Nien; Gan, Quan Fu; Saad, Hamimah

doi:10.1371/journal.pone.0250714

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…Therefore, this study added another line of evidence to our needs assessment studies [ 7 , 54 ], validation study [ 19 ], and formative research [ 26 ] in KEPT app development. The data demonstrated that pregnant women (with moderate-to-low income status) in our healthcare clinics are interested in the mHealth app intervention, indicating readiness for the realm of digital health.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Effectiveness of mHealth App-Based Pelvic Floor Muscle Training among Pregnant Women to Improve Their Exercise Adherence: A Pilot Randomised Control Trial

Jaffar

Sidik

Foo

et al. 2022

IJERPH

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This pilot randomised control trial (RCT) aimed to evaluate the feasibility and preliminary effectiveness of conducting a full-powered trial for a newly developed pelvic floor muscle training (PFMT) app among pregnant women with urinary incontinence (UI) in Malaysia. This was a prospective, single-centre, single-blind, parallel, randomised controlled, pilot feasibility study—the Kegel Exercise Pregnancy Training app (KEPT app) trial. In total, 26 pregnant women with urinary incontinence from an urban healthcare clinic were recruited and randomly assigned to either intervention or waitlist control group. The intervention group received the KEPT app, while the control group received usual antenatal care (waitlist control). Of the 26 pregnant women, 16 (61.5%) completed the two-month follow-up. The recruitment rate was 54.2%, and the retention rate was 62.5% in the intervention group and 60% in the control group. There was a significant difference between intervention and control groups’ baseline measurement in the severity of UI (p = 0.031). The app improved their knowledge (p = 0.011) and self-efficacy (p = 0.038) after the first month and attitude (p = 0.034) after two months of intervention, compared with the control group. This study supports the feasibility of our future cluster RCT. The KEPT app demonstrates a promising effect in improving PFMT attitude and self-efficacy and potentially enhancing exercise adherence among pregnant women with UI. Trial registration: This study was prospectively registered on ClinicalTrials.gov on 19 February 2021 (NCT04762433).

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Section: Discussionmentioning

confidence: 99%

Preliminary Effectiveness of mHealth App-Based Pelvic Floor Muscle Training among Pregnant Women to Improve Their Exercise Adherence: A Pilot Randomised Control Trial

Jaffar

Sidik

Foo

et al. 2022

IJERPH

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“…COM-B was used to select the correct intervention (ie, training the pelvic floor muscle) based on previous studies [ 41 , 42 ]. The PSD component of the system’s credibility and trustworthiness, with the expertise involved in the development, may add to the user’s sense of safety and reliability regarding the KEPT app.…”

Section: Discussionmentioning

confidence: 99%

“…A detailed understanding of at-risk pregnant women was established by conducting a cross-sectional study at a primary care clinic [ 41 ]. Within this study, we also determined the prevalence and severity of UI and its impact on participants’ QoL at a primary care clinic (user’s study setting) [ 41 , 42 ]. The findings from this study provided input for the content of their educational videos and short notes on PFMT, which were captured as frequently asked questions (FAQ).…”

Section: Methodsmentioning

confidence: 99%

Improving Pelvic Floor Muscle Training Adherence Among Pregnant Women: Validation Study

et al. 2022

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Background Mobile health apps, for example, the Tät, have been shown to be potentially effective in improving pelvic floor muscle training (PFMT) among women, but they have not yet been studied among pregnant women. Adherence to daily PFMT will improve pelvic floor muscle strength leading to urinary incontinence (UI) improvement during the pregnancy. Objective This study aims to document the validation process in developing the Kegel Exercise Pregnancy Training app, which was designed to improve the PFMT adherence among pregnant women. Methods We utilized an intervention mapping approach incorporated within the mobile health development and evaluation framework. The framework involved the following steps: (1) conceptualization, (2) formative research, (3) pretesting, (4) pilot testing, (5) randomized controlled trial, and (6) qualitative research. The user-centered design-11 checklist was used to evaluate the user-centeredness properties of the app. Results A cross-sectional study was conducted to better understand PFMT and UI among 440 pregnant women. The study reported a UI prevalence of 40.9% (180/440), with less than half having good PFMT practice despite their good knowledge. Five focus group discussions were conducted to understand the app design preferred by pregnant women. They agreed a more straightforward design should be used for better app usability. From these findings, a prototype was designed and developed accordingly, and the process conformed to the user-centered design–11 (UCD-11) checklist. A PFMT app was developed based on the mHealth development and evaluation framework model, emphasizing higher user involvement in the application design and development. The application was expected to improve its usability, acceptability, and ease of use. Conclusions The Kegel Exercise Pregnancy Training app was validated using a thorough design and development process to ensure its effectiveness in evaluating the usability of the final prototype in our future randomized control trial study.

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“…UI is troublesome, particularly during pregnancy, and affects women’s quality of life physically, emotionally, spiritually, and financially [ 4 - 6 ]. Those who experience it may resort to various methods to deal with the problem, including using pads or incontinence diapers and avoiding social situations because of embarrassment.…”

Section: Introductionmentioning

confidence: 99%

Persuasive Technology in an mHealth App Designed for Pelvic Floor Muscle Training Among Women: Systematic Review

Jaffar¹,

Tan²,

Sidik³

et al. 2022

JMIR Mhealth Uhealth

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Background Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is potentially effective for delivering PFMT to pregnant women. Persuasive technology in the development of such mobile apps may facilitate behavior change by improving adherence to the exercises. The Capability, Opportunity, and Motivation–Behavior (COM-B) model is potentially useful in selecting the appropriate interventions to be incorporated into the apps. Objective This review of mHealth apps for PFMT aims to describe the principles of persuasion used for each app and to propose mHealth app design features based on the COM-B model. Methods A systematic literature search was conducted to answer three main research questions: what are the available mHealth apps for PFMT in the published literature, what persuasive strategies were used in their studies how were they mapped to the COM-B model, and how effective were the selected persuasive strategies for PFMT adherence? We searched PubMed, CINAHL, Web of Science, Scopus, and local Malaysian databases such as MyCite and MyMedR for articles reporting mHealth apps used for the delivery of PFMT. We included original articles reporting experimental and cross-sectional studies, including pilot or feasibility trials. Systematic and narrative reviews were excluded. Narrative and thematic syntheses were conducted on the eligible articles based on the research questions. The Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Non-randomized Studies were used to assess study bias. Results Of the 169 records from the initial search, 10 (5.9%) articles meeting the selection criteria were included in this review. There were 8 mHealth apps designed for the delivery of PFMT. The Tät, which used 3 categories of persuasive system design, improved PFMT adherence and was cost-effective. Only 1 app, the iBall app, used all categories of persuasive system design, by including social support such as "competition" in its design. The Diário Saúde app was the only app developed using operant conditioning. All apps incorporated Tailoring and Expertise as part of their PSD strategies. Only 3 apps, the Diário Saúde, Tät, and Pen Yi Kang demonstrated improved PFMT adherence. Conclusions Persuasive technology used in mobile apps may target desired behavior change more effectively. The persuasive system design can be mapped to the COM-B model to explain its effectiveness on behaviour change outcomes.

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Quality of life among pregnant women with urinary incontinence: A cross-sectional study in a Malaysian primary care clinic

Cited by 10 publications

References 22 publications

Preliminary Effectiveness of mHealth App-Based Pelvic Floor Muscle Training among Pregnant Women to Improve Their Exercise Adherence: A Pilot Randomised Control Trial

Preliminary Effectiveness of mHealth App-Based Pelvic Floor Muscle Training among Pregnant Women to Improve Their Exercise Adherence: A Pilot Randomised Control Trial

Improving Pelvic Floor Muscle Training Adherence Among Pregnant Women: Validation Study

Persuasive Technology in an mHealth App Designed for Pelvic Floor Muscle Training Among Women: Systematic Review

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