Preconception and Diabetes Information (PADI) App for Women with Pregestational Diabetes: a Feasibility and Acceptability Study

Abstract

Diabetes mellitus increases the risk of adverse maternal and fetal outcomes. Preconception care is vital to minimise complications; however, preconception care service provision is hindered by inadequate knowledge, resources and care fragmentation. Mobile health technology, particularly smartphone apps, could improve preconception care and pregnancy outcomes for women with diabetes. The aim of this study is to co-create a preconception and diabetes information app with healthcare professionals and women with diabetes and explore the feasibility, acceptability and preliminary effects of the app. A mixed-methods study design employing questionnaires and semi-structured interviews was used to assess preliminary outcome estimates (preconception care knowledge, attitudes and behaviours), and user acceptability. Data analysis included thematic analysis, descriptive statistics and non-parametric tests. Improvements were recorded in knowledge and attitudes to preconception care and patient activation measure following the 3-month app usage. Participants found the app acceptable (satisfaction rating was 72%), useful and informative. The app’s usability and usefulness facilitated usage while manual data input and competing priorities were barriers which participants felt could be overcome via personalisation, automation and use of daily reminders. This is the first study to explore the acceptability and feasibility of a preconception and diabetes information app for women with diabetes. Triangulated data suggest that the app has potential to improve preconception care knowledge, attitudes and behaviours. However, in order for women with DM to realise the full potential of the app intervention, particularly improved maternal and fetal outcomes, further development and evaluation is required.

Interventions to enhance pre‐pregnancy care for women with type 2 diabetes: A systematic review of the literature

“…While not exclusively tailored towards women with type 2 diabetes, the centring of this intervention in mobile health, rather than specialist secondary care centres as in the reviewed studies, may contribute to making the intervention more accessible to this population. Two studies have been published relating to this protocol, exploring the feasibility and acceptability of the PADI app among women with pregestational diabetes and their clinicians, with both studies supporting its use 26,27 . However, to the authors knowledge, no studies assessing the effectiveness of the PADI app have yet been published.…”

“…Two studies have been published relating to this protocol, exploring the feasibility and acceptability of the PADI app among women with pregestational diabetes and their clinicians, with both studies supporting its use. 26,27 However, to the authors knowledge, no studies assessing the effectiveness of the PADI app have yet been published. There are two ongoing studies of relevance, with one based in the UK (the PREPARED study), 28 while the other is based in the US.…”

Digital communication through COVID: A free NHS app for patients with type 1 diabetes improves accessibility and self-management

“…A literature search was performed with the following terms: diabetes, app, type1, self-management, patient satisfaction. Very few articles were found, however Ashurst et al [9] and Nwolise [10] have published their experiences. These were used to form the questions in the survey.…”

Development and evaluation of a regional diabetes service App for patient education, self-management and clinic engagement

“…10 ) A literature search was performed with the following terms: diabetes, app, type 1, self-management, patient satisfaction. Very few articles were found; however Ashurst et al 11 and Nwolise et al 12 have published their experiences. These were used to form the questions in the survey.…”