Kraschnewski Jennifer L, Chuang Cynthia H, Poole Erika S, Peyton Tamara, Blubaugh Ian, Pauli Jaimey, Feher Alyssa, Reddy Madhu
Penn State University College of Medicine, Hershey, PA, United States.
J Med Internet Res. 2014 Jun 3;16(6):e147. doi: 10.2196/jmir.3385.
The prenatal care visit structure has changed little over the past century despite the rapid evolution of technology including Internet and mobile phones. Little is known about how pregnant women engage with technologies and the interface between these tools and medical care, especially for women of lower socioeconomic status.
We sought to understand how women use technology during pregnancy through a qualitative study with women enrolled in the Women, Infants, and Children (WIC) program.
We recruited pregnant women ages 18 and older who owned a smartphone, at a WIC clinic in central Pennsylvania. The focus group guide included questions about women's current pregnancy, their sources of information, and whether they used technology for pregnancy-related information. Sessions were audiotaped and transcribed. Three members of the research team independently analyzed each transcript, using a thematic analysis approach. Themes related to the topics discussed were identified, for which there was full agreement.
Four focus groups were conducted with a total of 17 women. Three major themes emerged as follows. First, the prenatal visit structure is not patient-centered, with the first visit perceived as occurring too late and with too few visits early in pregnancy when women have the most questions for their prenatal care providers. Unfortunately, the educational materials women received during prenatal care were viewed as unhelpful. Second, women turn to technology (eg, Google, smartphone applications) to fill their knowledge gaps. Turning to technology was viewed to be a generational approach. Finally, women reported that technology, although frequently used, has limitations.
The results of this qualitative research suggest that the current prenatal care visit structure is not patient-centered in that it does not allow women to seek advice when they want it most. A generational shift seems to have occurred, resulting in pregnant women in our study turning to the Internet and smartphones to fill this gap, which requires significant skills to navigate for useful information. Future steps may include developing interventions to help health care providers assist patients early in pregnancy to seek the information they want and to become better consumers of Internet-based pregnancy resources.
尽管包括互联网和手机在内的技术迅速发展，但过去一个世纪以来产前检查的结构变化甚微。对于孕妇如何使用技术以及这些工具与医疗保健之间的界面，尤其是社会经济地位较低的女性，人们了解甚少。
我们试图通过对参加妇女、婴儿和儿童（WIC）计划的女性进行定性研究，了解女性在孕期如何使用技术。
我们在宾夕法尼亚州中部的一家WIC诊所招募了年龄在18岁及以上且拥有智能手机的孕妇。焦点小组指南包括有关女性当前孕期情况、信息来源以及是否使用技术获取与怀孕相关信息的问题。会议进行了录音和转录。研究团队的三名成员使用主题分析方法独立分析每份转录本。确定了与所讨论主题相关的主题，对此达成了完全一致。
进行了四个焦点小组讨论，共有17名女性参与。出现了三个主要主题如下。首先，产前检查结构不是以患者为中心的，第一次检查被认为来得太晚，而且在怀孕早期检查次数太少，而此时女性对产前护理提供者有最多的问题。不幸的是，女性在产前护理期间收到的教育材料被认为没有帮助。其次，女性求助于技术（如谷歌、智能手机应用程序）来填补她们的知识空白。求助于技术被视为一种代际方式。最后，女性报告说，技术虽然经常使用，但有其局限性。
这项定性研究的结果表明，当前的产前检查结构不是以患者为中心的，因为它不允许女性在最需要的时候寻求建议。似乎发生了代际转变，导致我们研究中的孕妇转向互联网和智能手机来填补这一空白，而获取有用信息需要具备重要的技能。未来的步骤可能包括制定干预措施，以帮助医疗保健提供者在怀孕早期协助患者获取他们想要的信息，并成为更好的基于互联网的怀孕资源消费者。
