Developing a Digital Health Promotion Program for Pregnancy

怀孕期间的个人行为影响妊娠期体重增加，妊娠期糖尿病 除了后代的发育编程之外，还可能导致妊娠高血压综合征和先兆子痫。本申请是 旨在评估数字化技术的技术优点、可行性、可用性和潜在的商业应用， 平台和健康课程，以减少母亲和婴儿在怀孕期间和分娩后的健康风险。目前，没有针对怀孕期间和怀孕后的孕妇的基于证据的，可扩展的和全面的数字健康计划，并且CDC的糖尿病预防计划禁止孕妇使用。我们建议在怀孕期间和产后6个月期间实施18次数字健康计划的最初8次（怀孕期间6次，怀孕后2次），此时女性可能更容易接受健康行为。该计划将我们先前经过研究测试的基于团队的干预范式从具有多个面对面会议的硬拷贝课程转换为数字格式，由参与者通过数字平台通过视频会议管理交互式会议。参与者将收到一个数字秤，活动和睡眠跟踪器和一个血压计，与数字平台无线同步到每个参与者的个人仪表板帐户。无线跟踪和监控将跨多个指标、社交网络功能层进行，并向参与者发出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的手机、智能设备和计算机访问，以促进参与者互动、激励、同伴支持以及生物特征和行为监测。在两次会议之间，妇女参加目标，并从事与前一次会议的学习目标有关的行为学习活动。向妇女传递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。来自数字秤、血压、活动和睡眠跟踪器的日常数据，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和保密的传真或电子邮件。课程将侧重于：a）体重增加和能量平衡; B）怀孕期间的营养; c）体育活动; d）减轻压力; e）睡眠卫生; f）怀孕生理学和胎儿生长。产后课程包括a）预防抑郁症; B）母乳喂养; c）通过饮食和体育活动恢复健康的孕前体重; d）生活平衡和社会化。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，包括运动和烹饪指导视频，常见问题解答，膳食和小吃食谱以及怀孕健康指南来加强。我们将评估计划的可行性，可用性，资源，工具，分层支持，整个平台的相关性和满意度，工具和8个会议，由6个团队的5名女性/团队进行问卷调查，焦点小组和网络分析。此外，我们将专门评估参与者对各种应用程序组件和监控设备的使用情况。医疗保健提供者将被询问有关效用，满意度和建议，关于患者数据上传到EMR，电子邮件或传真以及通过调查对干预的看法。

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.