Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Radio, TV) Mobile Apps

Intervention Description: The Growing and Glowing campaign was a digital intervention designed to increase access to pregnancy-related health information for Black women in Hillsborough County, Florida. The campaign was based on multiple theories of behavior change and aimed to address the issue of low birthweight, which is disproportionately experienced by Black women. The campaign content was delivered through social media channels and a website, and was tailored to the unique needs of the target population. The content included short videos of local trusted healthcare experts and illustrated imagery, and covered topics such as weight gain and nutrition, prenatal care, general empowerment, and COVID-19. The campaign also featured prenatal care providers who were actively practicing in the area and provided connections to community resources. The campaign was launched publicly in March 2020 and ran for the first year. The campaign was evaluated using two cross-sectional surveys and digital metrics from Google Analytics. The results showed significant improvements in pregnancy-related intentions, awareness of local resources, and the importance of prenatal care among women aware of the campaign. , ,

Intervention Results: The results of the Growing and Glowing campaign showed significant improvements in pregnancy-related intentions among Black women in Hillsborough County, Florida. The campaign attained 1,234 followers, 805,437 impressions, and a reach of 19,875. The web series videos were viewed almost 27,000 times, with 89% average viewer retention, and the website attracted 2,634 unique page views. The evaluation surveys revealed significant improvements in positive pregnancy-related intentions, including intentions to talk about nutrition with a doctor, intentions to discuss weight and exercise, and positive trends in intentions to discuss breastfeeding and the baby’s weight. Additionally, women aware of the campaign had significantly higher awareness of local resources and the importance of prenatal care. Despite the limitations of the small sample size, the data collected provided important insights into pregnancy-related knowledge and attitudes of Black women, particularly during the COVID-19 pandemic.

Conclusion: The study concluded that the Growing and Glowing campaign, a digital intervention designed for and by Black women, was effective in delivering pregnancy-related health information to the target population in Hillsborough County, Florida. The campaign achieved significant improvements in pregnancy-related intentions and increased awareness of local resources and the importance of prenatal care among women aware of the campaign. The results also highlighted the potential of digital interventions to reach women who may fall outside traditional health advertising in a cost-effective manner, especially during a time when women are engaging in fewer in-person care visits and spending more time online. The study emphasized the benefits of digital advertising in reaching specific populations and the ability to rapidly pivot messages based on local circumstances, ensuring the conveyance of timely, important information. Additionally, the study underscored the need for creative solutions paired with rigorous evaluation methods to establish an evidence base for best practices in reaching pregnant Black women. Despite the limitations of the study, the data collected provided important information on pregnancy-related knowledge and attitudes of Black women, particularly during the COVID-19 pandemic.

Study Design: The study design was a pre-post evaluation of the Growing and Glowing campaign, which aimed to increase access to pregnancy-related health information for Black women in Hillsborough County, Florida. The evaluation included two cross-sectional surveys, one conducted before the campaign implementation and the other conducted after the first year of the campaign. The surveys examined pregnancy-related knowledge, attitudes, intentions, and behaviors, in alignment with the two theories underpinning the campaign strategy and content. The surveys were conducted using Qualtrics panels and digital advertisements on social media platforms, such as Facebook and Instagram, and recruitment focused on oversampling Black women. The study also used digital metrics from Google Analytics to understand the campaign’s reach and engagement across all platforms. ,

Setting: The study was conducted in Hillsborough County, Florida, which is located in the southeastern United States. The Growing and Glowing campaign was designed to reach Black women in this area and provide them with pregnancy-related health information tailored to their unique needs

Population of Focus: The target audience of the Growing and Glowing campaign was Black women in Hillsborough County, Florida. The campaign was designed to provide pregnancy-related health information tailored to the unique needs of this population, with a focus on addressing the issue of low birthweight, which is disproportionately experienced by Black women. The campaign messaging adopted a reproductive empowerment lens and focused on educating women on areas related to low birthweight, including weight gain and nutrition, prenatal care, general empowerment, and COVID-19. The campaign content was delivered through social media channels and a website, and was based on multiple theories of behavior change. ,

Sample Size: he baseline survey included 162 respondents, and the follow-up survey included 265 respondents. In both surveys, efforts were made to oversample Black women, and the majority of the respondents identified as Black. The sample size of the surveys may have limited statistical significance in results, which is a challenge for any study reaching a small audience at the county level. Despite these limitations, the data collected as part of this study provide important information on pregnancy-related knowledge and attitudes of Black women, particularly during the COVID-19 pandemic

Age Range: The age range of the respondents in both the baseline and follow-up surveys was 18 to 65 years old. The surveys included similar age ranges, income ranges, and proportion of responses who selected “Other” for their race.

Intervention Components (click on component to see a list of all articles that use that intervention): Organizational Changes Prenatal Care Access Access Telehealth/Virtual Care

Intervention Description: The OB Nest intervention involved a reduced-frequency prenatal care model enhanced with remote home monitoring devices and nursing support. Participants in the OB Nest group received 8 scheduled clinic appointments with an obstetrician or a certified nurse midwife, as well as 6 virtual (phone or online) connected care visits with an OB Nest registered nurse. These virtual visits consisted of home blood pressure and fetal heart rate evaluation. Additionally, the OB Nest model included home monitoring devices and an online prenatal community to support the pregnant women .

Intervention Results: The study found that participants in the OB Nest group had significantly higher satisfaction with care and lower prenatal-related stress compared to patients in the usual care group. Perceived quality of care was similar between groups. Adherence to the provision of American College of Obstetricians and Gynecologists prenatal services was similar in both arms. Maternal and fetal clinical outcomes were similar between groups. Total reported nursing time was higher in OB Nest. The study concluded that OB Nest is an innovative, acceptable, and effective reduced-frequency prenatal care model that resulted in higher patient satisfaction and lower prenatal stress while reducing the number of appointments with clinicians and maintaining care standards for pregnant women .

Conclusion: The study concluded that the OB Nest intervention is an innovative, acceptable, and effective reduced-frequency prenatal care model. It resulted in higher patient satisfaction and lower prenatal stress, while reducing the number of appointments with clinicians and maintaining care standards for pregnant women. The findings suggest that OB Nest is a step toward evidence-driven prenatal care that improves patient satisfaction .

Study Design: The study utilized a rigorous randomized controlled trial (RCT) design to compare the OB Nest prenatal care model with usual care. Participants were randomized to either OB Nest or usual care using a dynamic allocation system, with an algorithm minimizing imbalances in a 1:1 ratio across specific factors such as age, body mass index, and parity. The allocation sequence was concealed from the study nurse who enrolled and assessed the eligibility of participants. The study team nurses and clinicians were aware of the assigned arms after randomization occurred, and team members analyzing quantitative data were blinded to which intervention arm mothers were assigned to

Setting: The study was conducted as a single-center randomized controlled trial within the Outpatient Obstetric Division at Mayo Clinic, a tertiary care academic center in Rochester, Minnesota. The Mayo Clinic serves approximately 2400 pregnant women annually, and the trial took place between March 2014 and January 2015

Population of Focus: The target audience for the OB Nest prenatal care model and the study evaluating its effectiveness were low-risk pregnant women who were between 18 and 36 years old, at less than 13 weeks of gestation, and without a concurrent medical or obstetric complication, who had the ability to provide informed consent. The study aimed to evaluate the acceptability and effectiveness of the OB Nest model compared to traditional prenatal care for this specific population .

Sample Size: he study aimed to recruit 300 pregnant women, with 150 participants assigned to the OB Nest group and 150 participants assigned to the usual care group. The sample size was determined based on the power to detect differences in patient satisfaction, which was considered the most important endpoint for pregnant patients and caregiver representatives when creating the OB Nest bundle. The study was powered to detect differences in patient satisfaction with a 98% power to detect a difference of 7 points, based on a standard deviation of 14.4, with 10% attrition

Age Range: The study enrolled English-speaking pregnant women between 18 and 36 years old who were at less than 13 weeks of gestation. This age range was part of the enrollment criteria for the study .

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs Prenatal Care Access

Intervention Description: The intervention in the study was the SmartMoms Canada mHealth app, which was developed for both Android and IOS devices . The app was designed to promote healthy lifestyle behaviors such as physical activity, healthy diet, managing anxiety, and practicing adequate sleep hygiene among pregnant and postpartum women . The app was provided to the participants, who were given a minimum of one week to become familiar with the technological accessories, including a Fitbit Charge 2 fitness tracker and a BodyTrace scale . During the focus groups, the participants were asked to provide feedback on their experiences using the app, including its strengths and weaknesses, and suggestions for future improvements

Intervention Results: The study found that pregnant and postpartum women positively viewed the SmartMoms Canada app with respect to its ability to provide pregnancy guidance, pregnancy-specific exercises, and advice on sleep . The participants also expressed a desire for more feedback in the form of notifications, further interactivity to input their own goals, and short workout routines based on time availability and stage of pregnancy . Additionally, the women highlighted the importance of organizing the app based on their personal health preferences and emphasized the inclusion of overall maternal health, including exercise, nutrition, and mindfulness . Furthermore, the study revealed that the participants were critical of certain aspects of the app, such as its design and aesthetic, and expressed a need for more emphasis on physical activity and less focus on weight tracking . The women also shared their experiences with other mHealth services and expressed their technological proficiency and knowledge of pregnancy-specific mHealth services . Overall, the results indicated that the SmartMoms Canada app was well-received by the participants, who provided valuable feedback for its improvement and future development , .

Conclusion: The conclusion of the study highlighted the potential of the SmartMoms Canada app as a promising solution to address the gaps in healthcare provider communication related to weight during pregnancy, along with support on physical activity, diet, and sleep . The authors emphasized the importance of incorporating qualitative feedback to improve the app, including the integration and synchronization of Wi-Fi™ enabled accessories and the provision of greater feedback on weight gain . The study also underscored the significance of embedding evidence-based tools in daily healthcare routines and encouraging healthcare providers to integrate such tools in their practice . Furthermore, the authors suggested that the future of mHealth tools and their role in prenatal care will depend on the successful embedding of these evidence-based tools in daily health care routines and encouraging healthcare providers to integrate such tools in their practice . They also indicated that the findings from this study and future studies will contribute to offering home pregnancy care, patient empowerment, and revolutionizing prenatal care practices, ultimately contributing to improved maternal-fetal health outcomes .

Study Design: The study utilized a qualitative research design, specifically employing focus groups and thematic analysis to gather and analyze data . Two focus groups involving a total of 13 participants, consisting of both currently pregnant and recently postpartum women, were organized for the study . The focus groups were transcribed verbatim, and thematic analysis was undertaken using manual coding and NVivo software . Additionally, Likert-scale surveys were used to collect and analyze responses from the participants .

Setting: The study was conducted in Ottawa, Canada, which is the capital city of Canada . The focus groups and evaluations took place at the University of Ottawa, indicating that the research was carried out in an academic setting. This setting is significant as it reflects the potential for the SmartMoms Canada mHealth app to be integrated into the Canadian healthcare system and academic research environment.

Population of Focus: The target audience of the study on the SmartMoms Canada mHealth app is pregnant and postpartum women in Canada . The study aimed to evaluate the receptiveness, functionality, and future prospects of the app among this population. The participants in the study were women who were pregnant or had given birth to a baby within six months of the first scheduled focus group . The study aimed to assess the utility of the SmartMoms Canada mHealth app in improving weight outcomes during pregnancy and promoting healthful lifestyle behaviors such as physical activity, healthy diet, managing anxiety, and practicing adequate sleep hygiene

Sample Size: The study involved a total of 13 participants in two focus groups, with 11 pregnant women and 7 postpartum women initially expressing interest and eligibility to participate . Of these, 17 women attended the first appointment and were given the SmartMoms Canada app along with the necessary accessories. However, 4 women were lost to follow-up, leaving a total of 13 participants who took part in one of the two focus groups

Age Range: The average age of the participants in the study was 31.5 years, with a standard deviation of 3.28 years . This indicates that the participants were generally in their early thirties. However, the specific age range of the participants was not explicitly provided in the information available from the study.

Intervention Components (click on component to see a list of all articles that use that intervention): Prenatal Care Access Technology-Based Support

Intervention Description: The intervention in this study involved user engagement with a digital health platform called Maven during pregnancy. The engagement included various activities such as reading articles, watching class recordings, attending live web-based classes, and interacting with dedicated care advocates who are allied health professionals. Additionally, interactions with health care providers, including obstetrician/gynecologists (OB/GYNs), doulas, midwives, mental health providers, nutritionists, and wellness coaches, were also part of the intervention. The study assessed the number of messages sent by users to their care advocates and providers, as well as the number of appointments with providers. The pregnancy trimester of enrollment was used as a proxy for an individual’s time enrolled in the digital platform

Intervention Results: The study found that more users who reported avoiding in-person care also reported that the digital platform helped them understand warning signs and learn medically accurate information. In the adjusted models, all modes of digital service use were associated with avoiding in-person care in a dose-response manner. Users were more likely to avoid in-person care if they reported that Maven helped them recognize warning signs or learn medically accurate information. The study also found that understanding warning signs and learning medically accurate information from the digital platform were independently associated with in-person care avoidance

Conclusion: The study concluded that digital platforms, such as Maven, can be effective in helping pregnant individuals avoid in-person care. The educational pathway suggests that digital platforms can be particularly effective in helping users recognize warning signs and learn medically accurate information, which may help them avoid in-person care by recognizing when it is medically appropriate. The results suggest that digital platforms can provide information and tools that patients need to recognize warning signs, avoid medical misinformation, and decide when in-person care is medically appropriate during pregnancy. This study extends the available literature by assessing the potential influence of access to comprehensive digital health services on emergency room and in-person care avoidance during pregnancy

Study Design: This study is a retrospective cohort analysis that aims to assess the association between user engagement with a digital health platform, Maven, and user reports that the platform helped them avoid in-person care during pregnancy. The study included 5263 users who used the product during pregnancy and reported outcomes after delivery. The study controlled for various factors such as age, race and ethnicity, medical risk score, mental health conditions, pregnancy-related anxiety, parity, pregnancy trimester enrolled, and high Social Vulnerability Index (SVI) . The study found that the use of the digital platform was associated with a better understanding of medically accurate information and warning signs, which in turn was associated with the perceived influence of the digital platform on in-person care avoidance

Setting: The study was conducted as a retrospective cohort analysis, and the setting was not explicitly mentioned in the provided excerpts. However, it focused on assessing the association between user engagement with a digital health platform and user reports that the platform helped them avoid in-person care during pregnancy

Population of Focus: The target audience for this study includes pregnant individuals who were enrolled in the digital platform during their pregnancy between January 2020 and July 2022 and delivered at the time of data analysis in July 2022. These individuals were users of the digital health platform and completed health surveys at both onboarding to the pregnancy program and the postpartum program

Sample Size: The study included a total of 5263 users who used the digital health platform during pregnancy and reported outcomes after delivery

Age Range: The average age of the sample was 32.7 years with a standard deviation of 4.0 years. However, the age range of the sample was not explicitly mentioned in the provided excerpts

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Apps

Intervention Description: The study examided the use of a mobile prenatal care app called Babyscripts. The app was designed to deliver educational content and remotely monitor blood pressure and weight for expectant mothers. The educational content was based on American College of Obstetricians and Gynecologists (ACOG) standards and refined by a committee of four board-certified obstetricians at the George Washington University (GWU) School of Medicine. The app sent educational content to the expectant mother at gestation-appropriate times throughout the pregnancy, covering topics such as pregnancy progression, preexisting risk hazards such as alcohol intake, smoking, or drug abuse, advice to address these risk hazards, dietary and nutritional content, breastfeeding information, guidelines for appropriate weight gain, and warning signs for pregnancy complications. The app also integrated with a Wi-Fi-connected scale and blood pressure cuff to provide both feedback and alerts depending on the readings. The alerts were created to provide early warnings to patients and providers about aberrant data points with the hope of providing early detection of hypertensive disorders of pregnancy and abnormal weight gain, indicating an increased risk of gestational diabetes, nutritional deficiency, or edema associated with preeclampsia.

Intervention Results: The results of the study indicated that the use of the mobile prenatal care app, Babyscripts, was associated with a reduced number of in-person obstetric (OB) visits during pregnancy for low-risk patients. The average number of in-person OB visits during pregnancy was 7.8 for the experimental group using the app, compared to 10.2 for the control group receiving usual care. This reduction in in-person visits was statistically significant (P=.01). Importantly, there was no statistical difference in patient satisfaction (P>.05) or provider satisfaction (P>.05) between the experimental and control groups. This suggests that the use of the mobile prenatal care app did not compromise patient or provider satisfaction with prenatal care. Additionally, the study found that the reduced in-person visit schedule facilitated by the app did not lead to a reduction in patient or provider satisfaction.

Conclusion: The conclusion drawn from the study is that the use of the mobile prenatal care app, Babyscripts, resulted in a reduction in the number of in-person obstetric visits during pregnancy for low-risk patients, without compromising patient or provider satisfaction with prenatal care. The findings suggest that the app was effective in facilitating a reduced in-person visit schedule while maintaining patient and provider satisfaction. The study also highlighted the potential of mobile health apps in addressing the perceived barriers to reducing in-person visits for prenatal care. The authors concluded that the app did not replace in-person visits but rather complemented the current activities that occur at each visit, potentially allowing for more individualized discussions during in-person visits. The study also emphasized the importance of future research to identify predictors of adverse clinical outcomes in various populations to mitigate the risk of adverse events

Study Design: The app aimed to facilitate the integration of prenatal care into the lives of pregnant women and provide them with educational programs and remote monitoring capabilities. Additionally, the study highlighted that pregnant women are highly engaged with their health care decisions during pregnancy and may be more receptive to educational programs that can be delivered through a mobile health app.

Setting: The study setting for the research described in the provided PDF file was two obstetric (OB) and gynecology (GYN) offices in the United States: one in downtown Washington, DC, and one in suburban Maryland. Prenatal care was provided at both locations by OB and GYN physicians and nurse midwives. Low-risk women were cared for by obstetrician-gynecologists at both locations, and all deliveries took place at the GWU hospital in Washington, DC. The educational components and clinical triggers were developed and refined at GWU in Washington, DC, United States, working in conjunction with a local mobile health technology firm 1EQ and their product Babyscripts.

Population of Focus: The study focused on the use of a mobile prenatal care app, specifically designed to deliver educational content and remotely monitor blood pressure and weight for expectant mothers

Sample Size: 88

Age Range: The age range for the participants in the study was between 18 and 40 years. Women aged between 18 and 40 years, presenting for a first-trimester verification of pregnancy or new OB visit, and who were considered low-risk were eligible for enrollment in the study. Additionally, participants were required to regularly use a mobile phone and be fluent in English.