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.

“您要么在避孕，要么怀孕，而中间的步骤则缺失了”。因此，一名妇女在我们的定性研究中说，描述了我们试图填补的差距。我们正在开发一种数字工具，以支持生殖年龄的人们了解他们的怀孕偏好，并制定和实施生殖生活计划；有助于预防计划外的怀孕，改善妊娠计划，准备和结果，并减少孕产妇健康的不平等。英国的所有怀孕中的一半都是计划外的，并且在妊娠计划中进行的讨论在医疗机构中并不常规；这导致错过的机会在怀孕前优化健康。目前，十分之九的妇女怀有至少一个可修改的危险因素的受孕；这被广泛认为是孕产妇死亡率和发病率的主要因素，尤其是黑人和少数族裔群体的不平等现象。同时，在过去的几年中，在英国获得避孕困难也变得越来越困难生殖目标。此外，市场上有一个差距可以支持生殖时代的人确定其生育意图并制定生殖生活计划。我们的应用程序独特地结合了预防怀孕和准备需求。我们广泛的定性和定量研究（> 100个小时的访谈和调查数据> 3000人）已告知我们决定创建数字工具的决定，而该应用程序的内容，外观和感觉已被严格共同开发，这意味着整个工具是基于循证的，用户以用户为中心的。我们已经通过一系列问题的proffuce proffuce proffuce propperce off Roppord off Ropd ofd Ropd od Ropd ofd ropd ofd ofd ofd ofd off ropd ofd ofd ofd ofd ropd over ropd over ropd ofd ropd ofd ofd ofd ofd ofd ofd ofd ofd over seppect。我们的算法基于避免妊娠量表并通过广泛的数据分析得出的经过验证的愿望，可以准确预测妊娠的可能性。我们已经将该算法数字化，将其纳入应用程序中，并将其映射到生育意图类型（FIT）中，为那些具有适应性，怀孕可能性和量身定制建议的用户创建了一种简单的使用工具（请参阅支持数据1）。我们计划通过在互动性生殖生活中构建该应用程序，从而实现他们的偏好，从而进一步开发此应用程序，从而使他们的偏好能够确定他们的偏好。该应用将指导用户了解问题和提示的动态途径；支持个人反思自己的生殖目标。他们的答案将塑造提出的问题，鼓励更深入地参与。头像将用于改善可用性和参与度，以及内置的可选待办事项项目，并提醒用户实现目标。我们将使用COM-B的行为改变模型来指导开发；以人为本的方法可以提高自主性和自我效能感，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，我们将在相关设置（包括教育和医疗保健环境）中试用该应用程序，以获取初步数据。在项目端，我们将拥有一个完全共同开发的应用程序，该应用程序将准备实施。