Developing a Digital Health Promotion Program for Pregnancy

孕期个人行为影响孕期体重增加、妊娠期糖尿病 糖尿病和先兆子痫，以及后代的发育规划。此应用程序是 旨在评估数字产品的技术优势、可行性、可用性和潜在的商业应用 平台和健康课程，以减少孕期和产后母婴的健康风险。目前，还没有针对怀孕期间和怀孕后的孕妇的循证、可扩展和全面的数字健康计划，疾控中心的糖尿病预防计划是孕妇的禁忌。我们建议开发最初的8个疗程(6个孕期，2个孕后)，在怀孕期间和产后6个月期间实施18个疗程的数字健康计划，届时女性可能更容易接受健康的行为。该计划将我们之前经过研究测试的、基于团队的干预模式从具有多个面对面课程的硬拷贝课程转变为由参与者通过数字平台通过视频会议管理互动课程的数字格式。参与者将收到一个数字秤、活动和睡眠跟踪器以及一个血压计，该血压计可以与数字平台无线同步到每个参与者的个人仪表板账户。无线跟踪和监控将跨多个指标和社交网络功能层级进行，并向参与者发送基于时间和行为的通知，以确保计划的遵守。该应用程序将可通过移动电话、智能设备和计算机访问，以促进参与者互动、激励、同伴支持以及生物识别和行为监控。在课程间歇，妇女参与目标，并参与与前一课程的学习目标相关的行为学习活动。向妇女发送信息的基础是利用在线平台、加强活动、长期目标和社会交流。从电子秤、血压、活动和睡眠跟踪器获得的日常数据，当超出推荐参数时，将立即无缝传输到女性的EMR和医疗保健提供者的安全保密传真或电子邮件中。课程将侧重于：a)体重增加和能量平衡；b)孕期营养；c)体力活动；d)减轻压力；e)睡眠卫生；f)妊娠生理和胎儿发育。产后会议包括a)预防抑郁症；b)母乳喂养；c)通过饮食和体力活动恢复孕前健康体重；d)生活平衡和社交。所有团队会议都通过会议之间的活动、会后目标、教育视频游戏和其他数字资源得到加强，包括锻炼和烹饪指导视频、常见问题、膳食和零食食谱以及怀孕健康指南。我们将评估计划的可行性、可用性、资源、工具、层级支持、整个平台的相关性和满意度、工具和8次会议，并通过问卷调查、焦点小组和网络分析，由5名女性/团队组成的6个团队每周开展活动。此外，我们还将具体评估参与者对各种应用组件和监控设备的使用情况。将通过调查询问医疗保健提供者关于上传到EMR、电子邮件或传真的患者数据的实用性、满意度和建议，以及对干预的看法。

Personal behaviors during pregnancy influence gestational weight gain, gestational diabetes mellitus and preeclampsia, in addition to developmental programming of the offspring. This application is designed to assess the technical merit, feasibility, usability and potential commercial application of a digital platform and wellness curriculum to reduce the health risks of the mother and child during pregnancy and after delivery. Currently, there are no evidence-based, scalable and holistic digital health programs for pregnant women during and post pregnancy, and the CDC's Diabetes Prevention Program is contraindicated for pregnant women. We propose to develop the initial eight sessions (6 during pregnancy, 2 post-pregnancy) of an 18-session digital wellness program implemented during pregnancy and 6-months post-partum when women are likely to be more receptive to engage in healthy behaviors. The program translates our prior research-tested, team-based intervention paradigm from a hardcopy curriculum with multiple in-person sessions to a digital format with interactive sessions administered by the participants via the digital platform, by videoconferencing. Participants will receive a digital scale, activity and sleep tracker and a sphygmomanometer that syncs wirelessly with the digital platform to each participant's personal Dashboard account. The wireless tracking and monitoring will occur across several metrics, tiers of social networking functionality, with time and behavior- based notifications to participants to ensure program adherence. The application will be accessible by mobile phone, smart devices and computer to facilitate participant interaction, motivation, peer support, and biometric and behavior monitoring. Between sessions, women participate in goals and engage in behavioral leaning activities related to the prior session's learning objectives. Messaging to women is based upon online platform utilization, reinforcing activities, long-term goals and social communication. Daily data derived from the digital scale, blood pressure, activity and sleep tracker, when outside recommended parameters, will immediately be seamlessly transferred to the woman's EMR and healthcare provider's secure and confidential fax or email. Curriculum sessions will focus on; a) weight gain and energy balance; b) nutrition during pregnancy; c)physical activity; d) stress reduction; e) sleep hygiene; and f) pregnancy physiology and fetal growth. Postpartum sessions include a) depression prevention; b) breast feeding; c) return to healthy pre-pregnancy weight via diet and physical activity; d) life balance and socialization. All team sessions are reinforced with activities between meetings, post-session goals, educational videogames and other digital resources including, exercise and cooking instruction videos, FAQs, meal and snack recipes and a pregnancy wellness guide. We will assess program feasibility, usability, resources, tools, tier support, relevance and satisfaction of the entire platform, tools and 8 sessions an accompanying weekly activities by six teams of 5 women/team with questionnaires, focus groups, and web analytics. In addition, we will specifically assess participant usage of various application components and monitoring devices. Healthcare providers will be queried about utility, satisfaction and recommendations regarding patient data uploads to the EMR, email or fax and perceptions of the intervention by survey.