Foster Jennifer, Miller Lindsey, Isbell Sheila, Shields Tekesia, Worthy Natasha, Dunlop Anne Lang
Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Atlanta, GA 30322, USA;; Rollins School of Public Health, Emory University, 1520 Clifton Road Atlanta, GA 30322, USA.
Fox Valley Family Medicine Residency, 229 S. Morrison St. Appleton, WI 54911, USA.
Mhealth. 2015 Dec 15;1:20. doi: 10.3978/j.issn.2306-9740.2015.12.01. eCollection 2015.
The use of mobile phone applications (mHealth) to provide health education and behavioral prompts is 1 of the 12 common mHealth functions identified by the World Health Organization as innovations to strengthen health systems. Among low-income pregnant and parenting women, health education is widely recognized as a way to improve maternal and infant health outcomes, but the efficacy of written health education materials to change knowledge and behavior for this population is questionable. mHealth prompts, in contrast, is a promising alternative.
A team of researchers in medicine/epidemiology, anthropology/midwifery, computer science/sensors, and community-based case management created and pilot tested a mHealth application (mHealth app) for African-American women at high risk for adverse birth outcomes. We tested the acceptability and feasibility of the interactive application among women during the reproductive stages of early and late pregnancy, postpartum, and interconception.
Interview data from 14 women in the various reproductive stages revealed that most women found the mHealth messages helpful. Also, 62 Ob-Gyn physicians and nurses and 19 Family Medicine residents provided feedback. Women's responses to specific messages trended down over time. Women in the postpartum phase had the highest response rate to particular text messages, followed by those in the pregnancy phase. Responses dropped off dramatically during the interconception period. About 21% of women lost their phones. Unexpected findings were that all participants already had smartphones, women wanted messages about depression, and clinicians wanted the app to link to case management for individualized medical care.
Logistical challenges to app management were limitations but are useful for consideration before scale-up. This study corroborates findings in the health literacy literature that women most at risk for adverse birth outcomes need additional face-to-face support with mHealth applications.
使用手机应用程序（移动健康）来提供健康教育和行为提示，是世界卫生组织确定的12种常见移动健康功能之一，被视为加强卫生系统的创新举措。在低收入的孕妇和育儿女性中，健康教育被广泛认为是改善母婴健康结局的一种方式，但书面健康教育材料改变这一人群知识和行为的效果值得怀疑。相比之下，移动健康提示是一种有前景的替代方法。
一个由医学/流行病学、人类学/助产、计算机科学/传感器以及社区病例管理领域的研究人员组成的团队，为有不良分娩结局高风险的非裔美国女性创建并进行了移动健康应用程序（移动健康应用）的试点测试。我们在妊娠早期和晚期、产后以及受孕间隔期等生殖阶段测试了该互动应用程序在女性中的可接受性和可行性。
来自处于不同生殖阶段 的14名女性的访谈数据显示，大多数女性认为移动健康信息很有帮助。此外，62名妇产科医生和护士以及19名家庭医学住院医师提供了反馈。随着时间推移，女性对特定信息的回复呈下降趋势。产后阶段的女性对特定短信的回复率最高，其次是孕期女性。在受孕间隔期回复率大幅下降。约21%的女性丢失了手机。意外发现是所有参与者都已经拥有智能手机，女性希望收到有关抑郁症的信息，临床医生希望该应用程序能与病例管理相链接以提供个性化医疗服务。
应用程序管理方面的后勤挑战是限制因素，但在扩大规模之前值得考虑。本研究证实了健康素养文献中的研究结果，即分娩结局不良风险最高的女性需要通过移动健康应用程序获得更多面对面的支持。
