JMIR Publications

ABSTRACT

Background:

There are significant racial disparities in pregnancy and postpartum health outcomes, including postpartum weight retention and cardiometabolic risk. These racial disparities are a result of a complex interplay between contextual, environmental, behavioral, and psychosocial factors.

Objective:

This protocol provides a description of the development and infrastructure for the Postpartum Mothers Mobile (PMOMS) Study, designed to better capture women’s daily experiences and exposures from late pregnancy through one year postpartum. The primary aims of PMOMS are to understand the contextual, psychosocial, and behavioral factors contributing to racial disparities in postpartum weight and cardiometabolic health, with a focus on the daily experiences of stress and racism, as well as contextual forms of stress (e.g., neighborhood stress, structural racism).

Methods:

PMOMS is a longitudinal, observation study that is ancillary to an existing randomized control trial, GDM2. PMOMS uses an efficient and cost-effective approach for recruitment by leveraging the infrastructure of GDM2, facilitating enrollment of participants while consolidating staff support from the two studies. The primary data collection method is ecological momentary assessment (EMA) and smart technology (i.e., smart phones and scales). The development of the study includes: 1) Pilot phase and development of the smartphone-based application; 2) Feedback and further development of the application including selection of key measures; 3) Implementation, recruitment, and retention.

Results:

PMOMS aims to recruit 350 participants during pregnancy, to be followed through the first year after delivery. Recruitment and data collection started December 2017 and are expected to continue through September 2020. Initial results are expected December 2020. As of early May 2019, PMOMS recruited a total of 305 participants. Key strengths and features of PMOMS have included data collection via smartphone technology to reduce the burden of multiple on-site visits; low attrition rate due to participation in an ongoing trial in which women are already motivated and enrolled; high EMA survey completion and the use of EMA as a unique data collection method to understand daily experiences; and shorter than expected timeframe for enrollment due to the infrastructure of the GDM2 trial.

Conclusions:

This protocol outlines the development of the PMOMS study, one of the first published studies to use an ongoing EMA and mobile technology protocol during pregnancy and throughout one year postpartum to understand the health of childbearing populations and enduring racial disparities in postpartum weight and cardiometabolic health. Our findings will contribute to the improvement of data collection methods, particularly the role of EMA in capturing multiple exposures and knowledges in real-time, with less reliance on participant recall. Furthermore, the results of the study will inform future studies investigating weight and cardiometabolic health during pregnancy and the postpartum period, including how social determinants produce population disparities in these outcomes. Clinical Trial: Study does not include a clinical trial