JMIR Publications

ABSTRACT

Background:

Pregnancy is a complex period characterized by significant transformations. How a woman adapts to these changes can affect her quality of life and psychological well-being. Recently developed digital solutions have assumed a crucial role in supporting the psychological well-being of pregnant women. However, these tools have mainly been developed for women who already present clinically relevant psychological symptoms or mental disorders.

Objective:

This study aimed to develop a mindfulness-based well-being intervention for all pregnant women that can be delivered electronically and guided by a virtual assistant with wide reach and dissemination. This paper describes a technology-based mindfulness intervention's design and development process for pregnant women, including the exploration phase, intervention content development and iterative software development (including design, development, and formative evaluation of paper- and low-fidelity prototypes).

Methods:

Design and development processes were iterative and performed in close collaboration with key stakeholders (N=16), including pregnant women (n=2), mothers with young children (n=2), mindfulness experts (n=2), communication experts (n=2), psychologists (n=3) and midwives (n=4). User-centered and service design methods, such as interviews and usability testing, were included to ensure user involvement in each phase. Intervention content was developed by psychologists and mindfulness experts based on the Mindfulness-Based Childbirth and Parenting (MBCP) programme and adjusted to electronic format through multiple iterations with stakeholders.

Results:

An 8-session-based intervention in electronic format through text, audio, video, and images was designed. In general, the prototypes were evaluated positively by the users involved, but some valuable suggestions to improve the intervention and application were also identified. Prototyping revealed positive feedback, particularly regarding the comprehensibility of the chatbot's vocabulary. Qualitative interviews identified positive and negative aspects, informing further intervention refinement. Noteworthy observations include suggestions to incorporate auditory components alongside textual content or substitute text entirely with auditory or audiovisual formats. Debate surrounded the inclusion of background music in mindfulness exercises, with opinions divided on its potential to either distract or aid in engagement. Additionally, positive aspects highlighted in the interviews include the empathetic communication style, discourse fluidity, and perceived utility of intervention content.

Conclusions:

This study illustrates how user-centered and service designs can be applied to identify and incorporate essential stakeholder aspects in the design and development process. Combined with evidence-based concepts, this process facilitated the development of a mindfulness intervention designed for the end users, in this case, pregnant women.