Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 25, 2025
Date Accepted: Jul 30, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effects of Smartphone App-Based Exercise Management on Physical Activity, Fear of Childbirth, and Quality of Life among Pregnant Women in Indonesia: An Interventional Study
ABSTRACT
Background:
Pregnancy, a vital phase in a woman’s life, entails immense physical, psychological, and emotional alterations that might affect maternal health. Physical activity during pregnancy improves health outcomes; however, adherence to the recommendation is low. Moreover, fear of childbirth (FoC) has a negative impact on maternal mental health and quality of life (QoL). Mobile health (mHealth) interventions, especially those delivered through smartphone-based exercise management applications, provide a scalable solution to improve maternal health outcomes
Objective:
The purpose of this study was to assess the impact of an exercise management intervention based on a smartphone app on physical activity, FoC, and QoL in pregnant women in Indonesia
Methods:
A quasi-experimental design using repeated measures was conducted at Public Health Centers in West Java, Indonesia. We recruited 240 pregnant women who were randomly allocated to an intervention group (n=120) that received the app-based program and a control group (n=120) that only received standard prenatal care. Data were obtained at baseline (T0), after intervention (T1), and one month follow-up (T2). Outcomes were assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), Wijma Delivery Expectation Questionnaire (WDEQ-A), and Quality of Life Gravidarum (QOL-GRAV). Statistical analysis was conducted by repeated measures ANOVA with Bonferroni post-hoc tests. Cohen’s d was used to calculate effect sizes
Results:
The intervention group had significant increases in physical activity levels from T0 to T1 (p<0.001, Cohen’s d=0.65) and from T0 to T2 (p<0.001, Cohen’s d=0.72), whereas there were no significant changes in the control group. FoC scores were significantly lower at T1 (p<0.001, Cohen’s d=0.52) and T2 (p<0.001, Cohen’s d=0.56) compared to T0 in the intervention group, but no changes were observed in the control group. QoL scores increased significantly in the intervention group from T0 to T1 (p<0.001, Cohen’s d=0.60) and from T0 to T2 (p<0.001, Cohen’s d=0.68), while there were no significant changes noted in the control group
Conclusions:
The exercise management intervention utilizing the smartphone app was effective in increasing physical activity, reducing FoC, and improving QoL among Indonesian pregnant women. The intervention represents a scalable and accessible mechanism through which maternal health can be improved in limited resource contexts. Large-scale, long-term studies are needed to evaluate the sustainability of the benefits observed and the incorporation of mHealth solutions in standard prenatal management
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