Abstract
BackgroundPregnant women are increasingly using mobile apps to access health information during the antenatal period. Therefore, digital health solutions can potentially be used as monitoring instruments during pregnancy. However, a main factor of success is high user engagement.ObjectiveThe aim of this study was to analyze engagement and factors influencing compliance in a longitudinal study targeting pregnant women using a digital health app with self-tracking.MethodsDigitally collected data concerning demographics, medical history, technical aspects, and mental health from 585 pregnant women were analyzed. Patients filling out ≥80% of items at every study visit were considered to be highly compliant. Factors associated with high compliance were identified using logistic regression. The effect of a change in mental and physical well-being on compliance was assessed using a one-sample t test.ResultsOnly 25% of patients could be considered compliant. Overall, 63% left at least one visit blank. Influential variables for higher engagement included higher education, higher income, private health insurance, nonsmoking, and German origin. There was no relationship between a change in the number of physical complaints or depressive symptoms and study dropout.ConclusionsMaintaining high engagement with digital monitoring devices over a long time remains challenging. As cultural and socioeconomic background factors had the strongest influence, more effort needs to be directed toward understanding the needs of patients from different demographic backgrounds to ensure high-quality care for all patients. More studies need to report on compliance to disclose potential demographic bias.
Highlights
Pregnant women make up a significant proportion of the world’s population
41 patients (7.0%) actively decided to terminate the study before completion, mostly due to personal issues concerning time management, difficulties related to pregnancy, or family reasons
We found a steadily decreasing compliance rather than an abrupt dropout of participants, which could have been provoked by a specific factor that all participants were exposed to at the same time
Summary
Pregnant women make up a significant proportion of the world’s population. With an average age of 30 years, pregnant women represent a generation of patients eager to experience new technologies and extend medical care in the digital sector [1,2,3]. A PRO is defined as “a measurement based on a report that comes directly from the patient (i.e., study subject) about the status of a patient’s health condition without amendment or interpretation of the patient’s response by a clinician or anyone else” [6]. Many factors such as body mass index (BMI), physical symptoms, or even depressive symptoms can be assessed using PROs or validated questionnaires. Objective: The aim of this study was to analyze engagement and factors influencing compliance in a longitudinal study targeting pregnant women using a digital health app with self-tracking. More studies need to report on compliance to disclose potential demographic bias
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