In a recent study, the SmartMom digital program was able to provide valuable prenatal education through SMS text messaging.
There has been a significant rise in web- or mobile technology-based programs for prenatal education, but most of these have not been evaluated, according to a recent study published in JMIR Formulative Research.
Apps and text-based solutions which use mobile devices are known as mobile health (mHealth). The use of mHealth technology during pregnancy has continued to rise as mobile devices are more commonly used in daily lives. International studies found app use during pregnancy is seen in 50% to 75% of cases.
Important decisions such as weight management, antenatal care attendance, smoking cessation, decreased alcohol consumption, and increased breastfeeding are encouraged through prenatal education. These actions reduce the prevalence of cesarean birth, preterm birth, and low birth weight.
Changes in adverse health behaviors have been associated with mHealth. As only one-third of Canadian women attend prenatal classes, there is a need to expand prenatal education.
During the COVID-19 pandemic, an increase in enrollments was seen for Canada’s SmartMom program, a prenatal education program delivered by SMS text messaging. To determine how SmartMomimpacted women’s perceived information needs and preferences on prenatal education, investigators conducted a development and usability study.
SmartMom was developed to counter barriers for prenatal education such as location, weather and road conditions, low socioeconomic status, a lack of instructors, and perceived stigma. Enrollment criteria include being aged over 19 years, able to read in English, having a healthy singleton pregnancy, and receiving maternity care in British Columbia.
There were 6 focus groups in the study comprised of pregnant or recently pregnant individuals. Unpaid social media promotion, brochures at maternity clinics, and snowball sampling by recruited participants were used to form focus groups from August to December 2020.
Participants received a demographic questionnaire and copies of SmartMom messages. Over videoconference, participants were asked open-ended questions to ascertain their information-seeking behaviors, priority information needs, and access to information through mobile technology. Recorded sessions were then transcribed by a research team member.
There were 16 participants, half of which were aged 30 to 39 years and all of which lived with a partner. All participants also used a cell phone, received SMS text messages, used apps, and browsed the internet on their mobile devices.
For participants discussing phone use, phone use lasted 5 to 6 hours daily in 80% and 2 to 4 hours daily in 20%. Use of 1 or more app for prenatal educationwas seen in 81% of participants.Pregnancy or recent pregnancy during the COVID-19 pandemic was reported by all participants, 44% of which enrolled in SmartMom during pregnancy.
The first theme identified during analysis was, “Having reliable information is the most important thing.” Many participants sought information through Google and social media platforms but found it difficult to determine whether the information was trustworthy.
Constant Googling was reported by most patients, and many sought social connections during pregnancy. Social media was reported as an important method of prenatal education, and a significant reduction of in-person care during the COVID-19 pandemic increased the need for digital prenatal education.
The second theme was, “Valuing inclusive, local, and strength-based information.” Participants preferred to receive information based on a wide variety of experiences with pregnancy, and noted the lack of resources for expecting parents who were not the birther, had lower education or literacy, and were younger. Resources were also desired for Indigenous and LGBTQ populations.
Frustration was reported over information being from other countries, making it difficult to determine what was relevant. Mobile apps were often useful, allowing connections to other pregnant people. Participants were also dissatisfied with fear-based information, which was avoided through the use of SmartMom.
The final theme was, “It was nice to have that information fed to you.” The ease of receiving SMS text messages from SmartMom and the chance to have optional message streams was appreciate by participants.
Most participants agreed it would be useful to have information given through an app, and many also wanted to be able to connect to health care professionals through an app.
Overall, participants wanted trustworthy, local, tailored, and automatic information. SmartMom was indicated to be reliable, timely, relevant, and tailored, making it a valuable program.
Murray JB, Sharp A, Munro S, Janssen PA. Expectant parents' preferences for teaching by texting: development and usability study of SmartMom. JMIR Form Res. 2023;7:e44661. doi:10.2196/44661.