Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 22, 2024
Date Accepted: Jun 14, 2025
A digital lifestyle application for hypertension pregnancy: An intervention development study using the Person-based Approach
ABSTRACT
Background:
Little is known about the best way to support pregnant women with chronic hypertension to adopt evidence-based healthy behaviours that are proven to reduce blood pressure.
Objective:
In this study we worked with women and healthcare professionals to develop and optimise a digital lifestyle intervention (DAPHNY (Diet and Activity for Pregnancy Hypertension) App), for those with chronic hypertension during pregnancy.
Methods:
Using the Person-Based Approach to intervention development, we conducted focus groups with maternity healthcare professionals (n=23) and early feasibility testing with women who had experience of chronic hypertension during pregnancy which involved think-aloud interviews (n=11) followed by user testing (n=10). A content analysis of interview and focus group data suggested important modifications needed for behaviour change. These were implemented within the prototype DAPHNY App that was tested by a group of women. App usage data and user engagement patterns were captured. Patient and Public Involvement representatives supported the study from the outset. The study was approved by Wales Research Ethics Committee (22/WA/0130). Consent was obtained from all participants.
Results:
An evidence-based, theoretically informed lifestyle App, named DAPHNY, was developed involving women who have had experience of chronic hypertension during pregnancy and healthcare professionals. Logic models highlighted key intervention features to increase ongoing engagement and subsequent behaviour change. Participants viewed the DAPHNY App as a beneficial and, novel tool; filling a gap in existing lifestyle support for hypertension management. Participants who tested the App mostly accessed pages to record blood pressure and step count with informational pages accessed less often.
Conclusions:
Development of the DAPHNY App, underpinned by an established behavioural framework for developing digital interventions, provided new and important data about how to support women with chronic hypertension to engage in healthy behaviours, a currently overlooked aspect of blood pressure management.
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