Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle coaching program to (a) measure the application’s usage behavior and (b) explore users’ perceptions of its usefulness in GDM management. Quantitative data were collected from the 170 application users who had participated in the intervention arm of the RCT. Semi-structured interviews (n = 14) captured users’ experiences when using the application. Data were collected from June 2019 to January 2020. Quantitative data were analyzed descriptively, and interviews were analyzed thematically. Only 57/170 users (34%) logged at least one meal, and only 35 meals on average were logged for eight weeks because of the incorrectly worded food items and limited food database. On the contrary, an average of 1.85 (SD = 1.60) weight values were logged per week since the weight tracking component was easy to use. Many users (6/14 (43%)) mentioned that the automatic coach messages created an immediate sense of self-awareness in food choices and motivated behavior. The findings suggest that for GDM management, a largely automated mHealth application has the potential to promote self-awareness of healthy lifestyle choices, reducing the need for intensive human resources. Additionally, several gaps in the application’s design were identified which need to be addressed in future works.
Highlights
Gestational diabetes mellitus (GDM) is a well-established risk factor for future type 2 diabetes mellitus [1]
Our objective is to evaluate such an automated and resource-lean mobile health (mHealth) application for GDM in Singapore because it is important to understand the user experience for applying the application in a clinical setting
The mHealth application, i.e., Habits-GDM, analyzed in this study is a largely automated mHealth application-based lifestyle coaching program minimizing the need for intensive human resources
Summary
Gestational diabetes mellitus (GDM) is a well-established risk factor for future type 2 diabetes mellitus [1]. GDM affects 20–30% of pregnancies in Singapore, which is way above the global prevalence of 13.8% [2]. In Singapore, the current care plan for women with GDM includes providing them with information on health, nutrition, and self-care through face-to-face consultations [3]. These activities are resource-intensive, do not allow for learning to be spaced over time, and lastly, do not let patients revisit the information at their preferred time and pace [3]. There is a need to explore alternate ways to provide health information to women with GDM
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