A digital tool to support pregnancy planning, preparation and prevention

支持怀孕计划、准备和预防的数字工具

• 批准号: MR/Y503320/1
• 负责人: Jennifer Hall
• 金额: $ 29.74万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY503320%2F1
• 关键词: digital; tool; support; pregnancy; planning

"You're either on contraception or you're pregnant, and that middle step is missing". So said one woman in our qualitative research, describing the gap that we are attempting to fill. We are developing a digital tool to support people of reproductive age to understand their pregnancy preferences and to develop and implement a reproductive life plan; helping prevent unplanned pregnancies, improve pregnancy planning, preparations and outcomes, and reduce inequalities in maternal health.Nearly half of all pregnancies in the UK are unplanned, and discussions around pregnancy planning are not routine in healthcare settings; this results in missed opportunities to optimise health before pregnancy. Currently, over nine out of ten women conceive with at least one modifiable risk factor; this is widely recognised to be a major contributor to maternal mortality and morbidity, and particularly to the inequalities in outcomes for black and minority ethnic groups. Meanwhile, it has also become increasingly difficult to access contraception in the UK over the last few years which, when coupled with dissatisfaction and discontinuation of contraception, contributes to unplanned pregnancies, which are associated with increased risks of stillbirth, preterm birth, low birthweight, neonatal mortality and postnatal depression.There is an unmet and expressed need among people of reproductive age for support to develop and meet their reproductive goals. Furthermore there is a gap in the market for a tool that can support people of reproductive age identify their fertility intentions and develop a reproductive life plan. Our app uniquely combines both pregnancy prevention and preparation needs, in one place. Our extensive qualitative and quantitative research (>100 hours of interviews and survey data from >3000 people) has informed our decision to create a digital tool, while the content, look and feel of the app has been rigorously co-developed, meaning the whole tool is evidence-based and user centred.We have already co-developed a minimum viable product of the app which guides users through a series of questions about their reproductive preferences. Our algorithm, based on the validated Desire to Avoid Pregnancy Scale and derived through extensive data analysis, accurately predicts the probability of pregnancy. We have digitised this algorithm, incorporated it into the app, and mapped it to the Fertility Intention Typology (FIT), creating a simple-to-use tool for users who are presented with their FIT, likelihood of pregnancy, and tailored advice (see Supporting data 1).We plan to further develop this app by building in an interactive reproductive life plan, taking the user from simply identifying their preferences to taking actions to achieve them. The app will guide users through a dynamic pathway of questions and prompts; supporting the individual to reflect on their own reproductive goals. Their answers will shape the questions presented, encouraging deeper engagement. Avatars will be used to improve usability and engagement, along with in-built optional to-do items and reminders to help users achieve their goals.We will use the COM-B model of behaviour change to guide the development; this person-centred approach can increase autonomy and self-efficacy and will enable healthcare professionals to better support individuals to meet their aims. Once developed, we will pilot the app in relevant settings (including education and healthcare settings) to gain preliminary data. At project end we will have a fully co-developed app which will be ready for implementation.

“你要么在避孕，要么怀孕了，中间这一步就缺失了。”在我们的定性研究中，一位女性这样描述我们试图填补的差距。我们正在开发一种数字工具，以支持育龄人群了解他们的怀孕偏好，并制定和实施生殖生活计划；帮助预防意外怀孕，改善怀孕计划、准备和结果，减少孕产妇保健方面的不平等。在英国，近一半的怀孕是计划外的，关于怀孕计划的讨论在医疗机构中并不常见；这导致错过了孕前优化健康的机会。目前，十分之九以上的妇女怀孕时至少有一个可改变的风险因素；人们普遍认为，这是造成产妇死亡率和发病率的主要原因，特别是造成黑人和少数族裔群体在结果上的不平等。与此同时，在过去的几年里，在英国获得避孕措施也变得越来越困难，再加上对避孕措施的不满和停止，导致了计划外怀孕，这与死产、早产、低出生体重、新生儿死亡率和产后抑郁症的风险增加有关。育龄人口在发展和实现其生殖目标方面需要得到支助，这方面的需要尚未得到满足。此外，市场上还缺乏一种工具，可以帮助育龄人口确定其生育意图并制定生育生活计划。我们的应用程序独特地结合了预防怀孕和准备需要，在一个地方。我们进行了广泛的定性和定量研究（100小时的访谈和3000人的调查数据），这让我们决定创建一个数字工具，而应用程序的内容、外观和感觉都是经过严格合作开发的，这意味着整个工具是基于证据和以用户为中心的。我们已经共同开发了这个应用程序的一个最小可行产品，通过一系列关于他们的生殖偏好的问题来指导用户。我们的算法基于经过验证的避免怀孕愿望量表，并通过广泛的数据分析得出，准确地预测了怀孕的概率。我们将该算法数字化，并将其整合到应用程序中，并将其映射到生育意向类型学（FIT）中，为用户创建了一个简单易用的工具，用户可以看到他们的FIT、怀孕可能性和量身定制的建议（见支持数据1）。我们计划进一步开发这款应用，通过建立一个互动的生殖生活计划，让用户从简单地确定他们的偏好到采取行动来实现它们。该应用程序将引导用户通过问题和提示的动态路径；支持个体反思自己的生育目标。他们的回答将塑造提出的问题，鼓励更深入的参与。化身将用于提高可用性和参与度，以及内置的可选待办事项和提醒，以帮助用户实现他们的目标。我们将使用COM-B行为改变模型来指导发展；这种以人为本的方法可以提高自主性和自我效能，并使医疗保健专业人员能够更好地支持个人实现其目标。一旦开发完成，我们将在相关环境（包括教育和医疗环境）中试用该应用程序，以获得初步数据。在项目结束时，我们将有一个完全共同开发的应用程序，将准备实施。