Behavior Change App for Self-management of Gestational Diabetes: Design and Evaluation of Desirable Features

Background Gestational diabetes (GDM) has considerable and increasing health effects as it raises both the mother’s and the offspring’s risk for short- and long-term health problems. GDM can usually be treated with a healthier lifestyle, such as appropriate dietary modifications and sufficient physical activity. Although telemedicine interventions providing weekly or more frequent feedback from health care professionals have shown the potential to improve glycemic control among women with GDM, apps without extensive input from health care professionals are limited and have not been shown to be effective. Different features in personalization and support have been proposed to increase the efficacy of GDM apps, but the knowledge of how these features should be designed is lacking. Objective The aim of this study is to investigate how GDM apps should be designed, considering the desirable features based on the previous literature. Methods We designed an interactive GDM prototype app that provided example implementations of desirable features, such as providing automatic and personalized suggestions and social support through the app. Women with GDM explored the prototype and provided feedback in semistructured interviews. Results We identified that (1) self-tracking data in GDM apps should be extended with written feedback, (2) habits and goals should be highly customizable to be useful, (3) the app should have different functions to provide social support, and (4) health care professionals should be notified through the app if something unusual …Peer reviewe

Comparing the social capital and occupational balance of mothers with and without postnatal depression symptomology

Over 70,000 mothers in the UK suffer from postnatal depression, costing the NHS over £70,000 for each case. In Wales, 70% of women have no access to specialist perinatal mental health services. Women with postnatal depression experience debilitating symptoms which lead to multiple adverse outcomes. The biological and psychological causes are well established. Reduced social capital (quality and quantity of social interactions) and occupational imbalance (unequal distribution of daily activities) also increase the risk of postnatal depressive symptomology, but are less well understood. Occupational therapists maximise functioning within daily occupations (categorised as self-care, productivity, leisure and rest), using coping strategies and adaptation to overcome illness associated difficulties. Currently, few occupational therapists are involved in postnatal care. This mixed methods research aimed to explore how life experience and choices impact on the mothering role and whether daily routines affect mental health. A cross-sectional questionnaire was conducted with 212 mothers of children aged less than 18 months and living in Wales. The questions explored the social capital and occupational balance of the mothers, alongside the Edinburgh Postnatal Depression Scale used to identify depressive symptomology. Logistic regression was used to analyse the data, with no association seen between social capital and EPDS score. Women with low occupational balance were nearly 17 times more likely to have EPDS scores ≥9 than mothers with high occupational balance. Subsequently, semi-structured interviews and activity diaries were completed using purposive sampling with 9 mothers. The explanatory sequential approach involved the questionnaire influencing the design of the interviews. Thematic analysis of the qualitative data highlighted three main themes: (i) identity and stigma; (ii) role transition and balance; and (iii) negotiating stereotypes. These results identified areas of occupational therapy involvement, including transitional change, realistic role education and potential coping strategies, which may influence future occupational therapy interventions in perinatal care