Improving Pelvic Floor Muscle Training Adherence Among Pregnant Women: Validation Study

Abstract

Background Mobile health apps, for example, the Tät, have been shown to be potentially effective in improving pelvic floor muscle training (PFMT) among women, but they have not yet been studied among pregnant women. Adherence to daily PFMT will improve pelvic floor muscle strength leading to urinary incontinence (UI) improvement during the pregnancy. Objective This study aims to document the validation process in developing the Kegel Exercise Pregnancy Training app, which was designed to improve the PFMT adherence among pregnant women. Methods We utilized an intervention mapping approach incorporated within the mobile health development and evaluation framework. The framework involved the following steps: (1) conceptualization, (2) formative research, (3) pretesting, (4) pilot testing, (5) randomized controlled trial, and (6) qualitative research. The user-centered design-11 checklist was used to evaluate the user-centeredness properties of the app. Results A cross-sectional study was conducted to better understand PFMT and UI among 440 pregnant women. The study reported a UI prevalence of 40.9% (180/440), with less than half having good PFMT practice despite their good knowledge. Five focus group discussions were conducted to understand the app design preferred by pregnant women. They agreed a more straightforward design should be used for better app usability. From these findings, a prototype was designed and developed accordingly, and the process conformed to the user-centered design–11 (UCD-11) checklist. A PFMT app was developed based on the mHealth development and evaluation framework model, emphasizing higher user involvement in the application design and development. The application was expected to improve its usability, acceptability, and ease of use. Conclusions The Kegel Exercise Pregnancy Training app was validated using a thorough design and development process to ensure its effectiveness in evaluating the usability of the final prototype in our future randomized control trial study.

Knowledge, attitudes, and practices of pelvic floor muscle exercises among pregnant women visiting public hospitals

“…The results of our study regarding the practices of pregnant women performing PFMEs are inconsistent with the study, which highlighted that pregnant women had good knowledge, and half of those women were practicing PFMEs [7]. Another study reported similar results by recruiting 720 women during pregnancy and postpartum; approximately half of the pregnant women were performing these exercises during pregnancy, and most intended to perform them during the postpartum period [32].…”

“…Pelvic floor disorders include urinary incontinence (UI) and dyspareunia, which may lead to temporary or permanent effects [5]. Enuresis is the other name for UI, defined as unpremeditated urine discharge, which is prevalent among 57.7% of females in low-and middle-income countries [6,7]. It affects women's health and quality of life by restricting physical activities and eliciting employment-related issues, emotional disturbance, behavioral problems, travel limitations, sleep disorders, and hindered prayers [8].…”

Persuasive technologies design for mental and behavioral health platforms: A scoping literature review

“…Fig 5 shows the utilization frequency of the strategies from the PSD model from Table 5 . On average, 6.3 persuasive features were used in the publications utilizing the PSD model listed in Table 5 , with 14 being the highest number of utilizations within 1 application [ 32 ], and 3 being the lowest [ 33 ].…”

“…Furthermore, participant age details fluctuated among studies: while some omitted age specifics, others employed age brackets. For context, average participant ages were as follows: 31.6 years in Fenicio and Calvary’s study [ 48 ], 55.5 years in that by Mohadis and colleagues [ 32 ], 45.5 years in Renfrew and colleagues’ study [ 44 ], and 29.84 years in the work of Jaffar and colleagues [ 33 ]. The evaluation of each study hinged on 2 primary criteria: the outcome—categorized as mixed, positive, or negative—and the inherent risk of bias.…”

Concepts and Application of Tai Ji in Stroke Rehabilitation: A Narrative Review

“…In addition, there were no regulatory bodies for Tai Ji, and patients are in the dark about their therapist's capabilities in delivering and educating them on the proper effective Tai Ji move for stroke rehabilitation. Future studies could be conducted to validate Tai Ji with the incorporation within the mobile health development and evaluation framework for better usability and acceptability in stroke rehabilitation ( 76 ).…”