JMIR Publications

ABSTRACT

Background:

In Canada, 1 in 3 Canadian women undergo an abortion in their lifetime. Despite the liberal legal context, barriers continue to exist for women to access this service. This study concludes a three-phase study that uses a user-centered design methodology to co-design a digital platform to support women in British Columbia after a surgical abortion.

Objective:

The objectives for this study were to: (1) conduct a pilot study to demonstrate that myPostCare is feasible and acceptable to support follow-up care after a surgical abortion (2) utilize the findings to understand if myPostCare has the potential to improve contraceptive behavior and knowledge, emotional wellbeing and sexual health knowledge and (3) develop a better understanding of how innovative mobile solutions can support integrative health programs in British Columbia with the goal to expand to other sites across Canada.

Methods:

The study design was a mixed methods prospective pilot study to assess feasibility and acceptability of myPostCare.ca. Women (aged 14-45 years) were recruited from 2 urban abortion facilities in British Columbia who underwent a surgical abortion. Participants completed a baseline quantitative survey and were provided access to myPostCare.ca for up to 30 days. A follow-up quantitative survey was sent to their email at day 30. Qualitative interviews were conducted to explore user satisfaction and usability with the tool. Responses to questions in the surveys were summarized using descriptive statistics and system usability scale was scored as per instructions. A secure analytics platform was implemented to obtain data on overall use of the website by users. Qualitative analysis was conducted with NVivo using a thematic analysis approach. This study was approved by the local ethics board.

Results:

62 participants were recruited, 40% completed exit surveys (25/60) and 6 semi-structured interviews completed. Forty participants had undergone an immediate postabortion intrauterine device (IUD) insertion and 22 did not have an IUD inserted. Average age of participants was 30 years. Overall participants were satisfied with myPostCare.ca. System Usability Scale average score (SD) was 81.5(±9.7), and the median and IQR was 82.5 (77.5 - 87.5), which reveals that 75% of the respondents indicated an SUS of greater than 77 indicating high usability of the tool. 88% of participants changed their contraceptive method to an IUD. Web-based analytics demonstrated that there were 61 unique visitors to the site, the top pages visited were Post-procedure care, Emotional Well-Being and Contraception Explorer. The highest number of hits on the website was 35 and the longest time spent was 56 minutes. The overall email open rates were 80% with click rate of 36%. myPostCare.ca was satisfactory to support follow-up care after a surgical abortion.

Conclusions:

This study demonstrates that communities and individuals are important co-collaborators to develop a mobile innovation that facilitates access to high quality patient-centered abortion care. This is the first in Canada to incorporate mHealth, human-centered design and follow-up care for abortion. Clinical Trial: N/A