JMIR Publications

ABSTRACT

Background:

Research has shown an increase in patient education internet interventions, based in health communication tools via apps and mHealth applications to foster the relation and communication behaviour between physicians and patients and thereby improving clinical care. Specifically, in the medical field of obstetrics, safe communication behaviour plays a crucial role, and pregnant women in particular would benefit from digitally delivered interventions to improve their safe communication behaviour. However, research testing this is scarce. Thus, little is known about the success of such an endeavour, potential behavioural barriers for engagement, as well as the processes by which such an internet intervention might improve safe communication behaviour.

Objective:

The current study filled this research gap, by applying a web-app aimed to improve pregnant women’s safe communication behaviour in clinical care.

Methods:

Thereby the focus lay on investigating the processes behind safe communication behaviour while identifying potential barriers for engagement with the web-app´s content.

Results:

N= 1187 pregnant women were recruited and started participating in the web app. The ten lessons in the web app targeted participants intention, planning, self-efficacy, and outcome expectancy beliefs to improve safe communication behaviour. The intervention was based on the Health Action Process Approach (HAPA) model, that has proven fruitful in explaining safe communication behaviour within previous research. Firstly, a behavioural risk factor for early internet intervention dropout was identified: younger age at intervention start. Additionally, our analyses revealed that capacity for action planning was the best predictor for successful behavioural change over the course of the app. Lastly, sequential mediation analyses revealed a mechanism behind this change, whereby self-efficacy beliefs affected the intention to communicate safely which in turn elicited action planning and thereby improved safe communication behaviour.

Conclusions:

Concluding, this research shows how internet supported interventions can be utilized to improve pregnant women´s safe communication behaviour in obstetrics care. Interventions improved safe communication behaviour along the constructs of the HAPA framework and thus similarly to a broad range of other health behaviours. Future research should build upon the gained insights conducting similar internet interventions in related fields of clinical care and/ or improve upon insights relating to processes of behaviour change, internet intervention success and minimizing dropout. Clinical Trial: ClinicalTrials.gov Identifier: NCT03855735