Views of Women and Health Professionals on mHealth Lifestyle Interventions in Pregnancy: A Qualitative Investigation.
Views of Women and Health Professionals on mHealth Lifestyle Interventions in Pregnancy: A Qualitative Investigation.
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DOI：
10.2196/mhealth.4869
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发表时间：
2015-10-28
影响因子：
5
通讯作者：
Campbell KJ
中科院分区：
文献类型：
--
作者：
Willcox JC;van der Pligt P;Ball K;Wilkinson SA;Lappas M;McCarthy EA;Campbell KJ
有证据表明，女性在怀孕期间未能达到营养、体力活动和体重增加的指导方针。促进孕期健康生活方式的干预措施效果好坏参半，而且许多干预措施都需要大量时间和资源。移动医疗提供的干预措施提供了及时且经济高效地提供可信来源信息的机会。关于妇女和卫生专业人员对产前保健中移动医疗的看法的研究有限。本研究旨在探讨女性和健康专业人士对移动医疗信息来源和干预措施的看法，以帮助女性在怀孕期间吃得好、锻炼身体并获得健康的体重。描述性定性研究方法采用焦点小组和对 15 名孕妇或产后妇女的深入访谈，以及对健康专业人员的 12 次深度访谈，其中每个类别有两名：产科医生、全科医生、助产士、营养师、物理治疗师和社区药剂师。所有采访均逐字记录并进行主题分析。妇女一致接受移动医疗信息源和产前保健干预措施的概念，并将其视为信息获取的核心，并最好纳入未来的产前保健流程。医疗专业人士表达了不同的观点，认为移动医疗是一种不可避免的、通常是并行的服务，而不是融入护理模式的服务。出现了四个关键主题：参与度、风险感知、责任和功能。女性将获取移动医疗元素的能力视为一种自我管理或控制信息获取的方式，而传统护理模式和信息来源无法提供这些信息。一些卫生专业人员认为，技术的出现已经将信息的控制从卫生专业人员和卫生组织等可信来源转移到了不可信来源。一些卫生专业人士担心移动医疗的法医学风险（不正确或有害的信息以及隐私问题），而其他人则承认，如果解决固有风险，移动医疗是可行的。在这两个群体中，谁应该负责确保高质量的移动医疗还存在不确定性。缺乏重要的怀孕或妇女权益团体、缺乏用于技术的卫生资金以及妇产医院被认为无力采用技术被认为是提供技术的主要障碍。女性一致认为移动医疗的功能可以为产前护理模式增加价值。对于一些卫生专业人员来说，对移动医疗缺乏熟悉和恐惧限制了他们对支持产前护理的新技术能力的参与和理解。妇女对移动医疗在产前护理中促进健康生活方式表现出积极的看法。相反，卫生专业人员表达了更广泛的态度差异，并且更有能力识别开发和实施的潜在风险和障碍。这项研究有助于了解在产前保健中发展移动健康生活方式干预措施的机遇和挑战。
Evidence suggests that women are failing to meet guidelines for nutrition, physical activity, and weight gain during pregnancy. Interventions to promote a healthy lifestyle in pregnancy demonstrate mixed results and many are time and resource intensive. mHealth-delivered interventions offer an opportunity to provide trusted source information in a timely and cost-effective manner. Studies regarding women’s and health professionals’ views of mHealth in antenatal care are limited. This study aimed to explore women’s and health professionals’ views regarding mHealth information sources and interventions to assist women to eat well, be physically active, and gain healthy amounts of weight in pregnancy. A descriptive qualitative research approach employed focus groups and in-depth interviews with 15 pregnant or postpartum women and 12 in-depth interviews with health professionals including two from each category: obstetricians, general practitioners, midwives, dietitians, physiotherapists, and community pharmacists. All interviews were transcribed verbatim and thematically analyzed. Women uniformly embraced the concept of mHealth information sources and interventions in antenatal care and saw them as central to information acquisition and ideally incorporated into future antenatal care processes. Health professionals exhibited varied views perceiving mHealth as an inevitable, often parallel, service rather than one integrated into the care model. Four key themes emerged: engagement, risk perception, responsibility, and functionality. Women saw their ability to access mHealth elements as a way to self-manage or control information acquisition that was unavailable in traditional care models and information sources. The emergence of technology was perceived by some health professionals to have shifted control of information from trusted sources, such as health professionals and health organizations, to nontrusted sources. Some health professionals were concerned about the medicolegal risks of mHealth (incorrect or harmful information and privacy concerns), while others acknowledged that mHealth was feasible if inherent risks were addressed. Across both groups, there was uncertainty as to who should be responsible for ensuring high-quality mHealth. The absence of a key pregnancy or women’s advocacy group, lack of health funds for technologies, and the perceived inability of maternity hospitals to embrace technology were seen to be key barriers to provision. Women consistently identified the functionality of mHealth as adding value to antenatal care models. For some health professionals, lack of familiarity with and fear of mHealth limited their engagement with and comprehension of the capacity of new technologies to support antenatal care. Women exhibited positive views regarding mHealth for the promotion of a healthy lifestyle in antenatal care. Conversely, health professionals expressed a much wider variation in attitudes and were more able to identify potential risks and barriers to development and implementation. This study contributes to the understanding of the opportunities and challenges in developing mHealth lifestyle interventions in antenatal care.