Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 25, 2019
Date Accepted: May 14, 2020
Do pregnant women with overweight and obesity find a nutrition and exercise intervention with smartphone app support acceptable? Findings from the PEARs randomised controlled trial.
ABSTRACT
Background:
Dietary interventions can improve pregnancy outcomes amongst women with increased BMI. Furthermore, interest in mobile health (mHealth) is growing but little is known about the acceptability of a smartphone app to support lifestyle interventions among such a cohort.
Objective:
We aimed to assess the acceptability of the PEARs study and the use of mHealth in a mixed lifestyle intervention.
Methods:
PEARs was a randomised controlled trial of a low glycaemic index (GI) dietary intervention with exercise prescription and smartphone app, delivered to pregnant women with overweight and obesity. Acceptability questionnaires were completed by the intervention group at 28 weeks’ gestation (n = 149) and post-intervention (n = 123). Maternal characteristics were recorded (age, ethnicity, BMI, socioeconomic status). Associations between maternal characteristics and acceptability of the intervention and app were analysed using t-tests, Mann-Whitney U tests, chi-squares and logistic regression. One-on-one semi-structured interviews were conducted with a sub-cohort of intervention participants (n = 28) at 34 weeks’ gestation, in which participants shared their experience of the PEARs intervention.
Results:
The intervention was generally accepted, with respondents agreeing that the diet was easy to follow (68.5%), enjoyable (74.1%) and affordable (76.9%). Qualitative and quantitative results were consistent with one another, both demonstrating that app acceptability was high. Participants agreed that the app was enjoyable (80%) and easy to use (97.5%). Compared to those with tertiary education, those with lower education were more likely to enjoy the dietary changes (P = .039). Enjoyment of the app was associated with disadvantaged neighbourhood deprivation index (P = .012) and higher BMI (B = .172, P = .029).
Conclusions:
The PEARs intervention and use of a supportive smartphone app were accepted by pregnant women, particularly by those from vulnerable subgroups of the population. Clinical Trial: https://www.isrctn.com/, ISRCTN29316280
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