JMIR Publications

ABSTRACT

Background:

Gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) impose psychosocial burdens on pregnant individuals. We sought to identify the psychosocial burdens of having diabetes during pregnancy and understand how a novel smartphone application may alleviate them.

Objective:

This study analyzes qualitative data generated in a feasibility randomized controlled trial of a novel mobile app designed to promote self-management skills, motivate healthy behaviors, and inform low-income pregnant individuals with diabetes.

Methods:

Individuals were randomized to use of the SweetMama app (n=30) or usual care (n=10) from diagnosis of diabetes until 6-weeks postpartum. All individuals completed exit interviews at delivery about their experience of having diabetes during pregnancy. SweetMama users were also queried about their perspectives on the app. Interview data were analyzed using constant comparative techniques.

Results:

Of the 40 participants, the majority had GDM (63%), publicly-funded prenatal care (83%), and identified as non-Hispanic Black (68%) or Hispanic (28%). Participants identified multiple psychosocial burdens, including: challenges taking action, negative affectivity regarding diagnosis, diet guilt, difficulties managing other responsibilities, and reluctance to use insulin. SweetMama participants largely agreed use of the app helped mitigate these burdens by enhancing self-efficacy, capitalizing on external motivation, validating efforts, sustaining medical nutrition therapy, extending clinical care, and building a sense of community.

Conclusions:

Psychosocial burdens of diabetes during pregnancy present challenges with diabetes self-management. Mobile health support may be an effective tool to provide motivation, behavioral cues, and access to educational and social network resources to alleviate psychosocial burdens during pregnancy. Clinical Trial: ClinicalTrials.gov NCT03240874