JMIR Publications

ABSTRACT

Background:

Substance use is a leading cause of maternal morbidity and mortality. Pregnancy apps are a ubiquitous source of pregnancy information, but their utility for evaluating substance use during pregnancy is unknown.

Objective:

To explore the usability and acceptability of a prenatal app for substance use screening and education during pregnancy.

Methods:

We conducted a mixed-methods, exploratory pilot study among 28 pregnant persons aged ≥ 18 years, with regular smartphone access, and who had a history of substance use. After completing a baseline survey collecting demographics, substance use, and technology use information, participants were given access to an existing prenatal support app for approximately 4 weeks. Qualitative methods (i.e., think aloud and cognitive interviews) were used to understand participants’ perspectives on the usability and acceptability of embedding substance use screening, education, and information within the tool. App usage data was also evaluated.

Results:

Among participants, 67.9% reported previously using one or more prenatal apps and 10.7% cited prenatal apps as their most frequently used source of pregnancy information. Over the approximate 4-week period of app exposure, 71.4% logged into the app daily or weekly, 89.3% reported that they were satisfied with the app, and 96.4% reported that the app was a helpful source of support. In cognitive interviews, participants reported that app-based disclosure of substance use, through such a tool, could be easier than disclosing in-person due to reduced stigma or perceived judgement. However, participants also expressed concerns about disclosure related to not knowing who would have access to this information.

Conclusions:

Incorporating substance use screening, education and information into a pregnancy app was found to be acceptable among a pregnant persons with substance use.