A Technology-Based Pregnancy Health and Wellness Intervention (Two Happy Hearts): Case Study

Abstract

Background The physical and emotional well-being of women is critical for healthy pregnancy and birth outcomes. The Two Happy Hearts intervention is a personalized mind-body program coached by community health workers that includes monitoring and reflecting on personal health, as well as practicing stress management strategies such as mindful breathing and movement. Objective The aims of this study are to (1) test the daily use of a wearable device to objectively measure physical and emotional well-being along with subjective assessments during pregnancy, and (2) explore the user’s engagement with the Two Happy Hearts intervention prototype, as well as understand their experiences with various intervention components. Methods A case study with a mixed design was used. We recruited a 29-year-old woman at 33 weeks of gestation with a singleton pregnancy. She had no medical complications or physical restrictions, and she was enrolled in the Medi-Cal public health insurance plan. The participant engaged in the Two Happy Hearts intervention prototype from her third trimester until delivery. The Oura smart ring was used to continuously monitor objective physical and emotional states, such as resting heart rate, resting heart rate variability, sleep, and physical activity. In addition, the participant self-reported her physical and emotional health using the Two Happy Hearts mobile app–based 24-hour recall surveys (sleep quality and level of physical activity) and ecological momentary assessment (positive and negative emotions), as well as the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. Engagement with the Two Happy Hearts intervention was recorded via both the smart ring and phone app, and user experiences were collected via Research Electronic Data Capture satisfaction surveys. Objective data from the Oura ring and subjective data on physical and emotional health were described. Regression plots and Pearson correlations between the objective and subjective data were presented, and content analysis was performed for the qualitative data. Results Decreased resting heart rate was significantly correlated with increased heart rate variability (r=–0.92, P<.001). We found significant associations between self-reported responses and Oura ring measures: (1) positive emotions and heart rate variability (r=0.54, P<.001), (2) sleep quality and sleep score (r=0.52, P<.001), and (3) physical activity and step count (r=0.77, P<.001). In addition, deep sleep appeared to increase as light and rapid eye movement sleep decreased. The psychological measures of stress, depression, and anxiety appeared to decrease from baseline to post intervention. Furthermore, the participant had a high completion rate of the components of the Two Happy Hearts intervention prototype and shared several positive experiences, such as an increased self-efficacy and a normal delivery. Conclusions The Two Happy Hearts intervention prototype shows promise for potential use by underserved pregnant women.

Monitoring one heart to help two: heart rate variability and resting heart rate using wearable technology in active women across the perinatal period

“…Wearable technology is an increasingly popular area of fitness tracking and in vivo data collection that opens doors for novel data collection in the area of pregnancy fitness [ 6 ]. The WHOOP® strap (Strap 2.0; WHOOP, Inc., Boston, MA, USA) is a commercially available wearable device that provides continuous physiologic data monitoring and training recommendations based on proprietary scientific research [ 7 ].…”

“…Limited research has started to use continuous monitoring of different physiological variables with wearable technology during pregnancy [ 6 , 14 , 15 ]. However, these are limited by short length of monitoring, lack of monitoring of both HRV and RHR, and/or limited participants (case study) [ 6 ].…”

“…Limited research has started to use continuous monitoring of different physiological variables with wearable technology during pregnancy [ 6 , 14 , 15 ]. However, these are limited by short length of monitoring, lack of monitoring of both HRV and RHR, and/or limited participants (case study) [ 6 ]. This is a burgeoning field of study and the potential to increase the time of follow-up during the perinatal period, measure HRV and RHR, and include an adequate sample of participants provides the potential to inform future research and current clinical practice.…”

Monitoring One Heart to Help Two: Heart Rate Variability and Resting Heart Rate using Wearable Technology in Active Women Across the Perinatal Period

“…Wearable technology is an increasingly popular area of fitness tracking and in vivo data collection that opens doors for novel data collection in the area of pregnancy fitness. 6 The WHOOP® strap (Strap 2.0; WHOOP, Inc., Boston, MA, USA) is a commercially available wearable device that provides continuous physiologic data monitoring and training recommendations based on proprietary scientific research. 7 WHOOP® uses heart rate variability (HRV), along with resting heart rate (RHR) and sleep patterns to determine readiness for activity.…”

“…12 Limited research has started to use continuous monitoring of different physiological variables with wearable technology during pregnancy. 6,14,15 However, these are limited by short length of monitoring, lack of monitoring of both HRV and RHR, and/or limited participants (case study). 6 This is a burgeoning field of study and the potential to increase the time of followup during the perinatal period, measure HRV and RHR, and include an adequate sample of participants provides the potential to inform future research and current clinical practice.…”