JMIR Publications

ABSTRACT

Background:

Maternal health during the perinatal period is a global public health priority. While antenatal education is widely implemented, conventional lecture-based models often fail to achieve sustained behaviour change. Innovative approaches that integrate experiential learning with digital support may enhance maternal knowledge, self-management, and pregnancy outcomes.

Objective:

To evaluate the feasibility and preliminary effectiveness of a combined experiential class and online logging intervention for pregnant women in China, and to explore the mechanisms underpinning its impact on health practices and service experiences.

Methods:

A mixed-methods design was employed in a district-level maternal and child health hospital in Beijing. In the quantitative arm, 40 women (intervention group, n=20; control group, n=20) were enrolled in a quasi-experimental comparison. Outcomes included knowledge-attitude-practice (KAP) indicators, service satisfaction, and clinical birth outcomes. Given the limited sample size, a qualitative arm was conducted to complement statistical findings: semi-structured interviews with 20 women (10 per group) were analyzed thematically. Quantitative and qualitative results were integrated during interpretation to provide a comprehensive evaluation.

Results:

Compared with experiential class alone, the combined intervention was associated with higher knowledge scores (mean difference 1.6 points, 95% CI 0.8 to 2.4), stronger adherence to recommended health practices (composite adherence score difference 1.0, 95% CI 0.4 to 1.6), and higher overall service satisfaction (mean difference 0.6, 95% CI 0.2 to 1.0). Across multiple domains, a higher proportion of participants in the intervention group met dietary, exercise, and supplementation recommendations. Clinical outcome differences were exploratory, as the study was not powered for these endpoints. Qualitative analysis revealed three mechanisms-empowerment and self-efficacy, practice and persistence, and systemic/environmental support-through which the intervention influenced experiences and practices.

Conclusions:

The experiential class plus online logging model is feasible and acceptable in a real-world antenatal setting. While limited by small sample size, findings suggest the intervention improves maternal knowledge, health practices, and service experiences, and may inform future adequately powered trails to evaluate pregnancy outcomes. Qualitative insights highlight mechanisms of health practices change and provide contextual depth, underscoring the value of mixed-methods designs in maternal health research.