Perspectives on mHealth Interventions During and After Gestational Diabetes

Abstract Objectives To systematically review the perspectives of women with gestational diabetes (GDM) or a recent history of GDM on mHealth lifestyle interventions during pregnancy and postpartum to inform future intervention development. Methods This systematic review was published according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research was conducted in PubMed, MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Central Register of Controlled Trials for qualitative studies up until 28 April 2020. Study quality was evaluated using Joanna Briggs Institute critical appraisal checklist for qualitative research and a reflexive thematic synthesis was performed. The COM-B model was used to apply findings to improve future intervention development. Results 14 studies met the inclusion criteria representing the views of 327 women. Differences emerged within the themes identified in pregnancy and postpartum. In pregnancy 3 overarching themes emerged relating to mHealth interventions- support, connectedness and trust. Pregnant women valued the support of healthcare professionals (HCPs) when participating in mHealth interventions, along with information from sources they can trust. The use of self-monitoring was useful in pregnancy as they could see their progress and feel connected to their pregnancy. Using mHealth alongside usual care in pregnancy was seen as beneficial. Postpartum 2 overarching themes emerged- support and connectedness. Postpartum women did not value the input of HCPs as much as pregnant women. They valued connections made with their peers. They indicated more limitations with mHealth interventions than women during pregnancy. They discussed the use of rewards to remain motivated, while in pregnancy the health of the baby appeared to be the main motivator. 7 key recommendations have been made for future intervention design using the COM-B model, most with high or moderate confidence. Conclusions Women's views on mHealth lifestyle interventions differ between pregnancy and the postpartum period, and these needs should be reflected in intervention design. The results also reflect the impact a GDM diagnosis has on women highlighting the need for ongoing support continuing into postpartum. Funding Sources No funding was received for this research.