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Postpartum patient engagement mHealth intervention during COVID-19: a mixed methods study
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Sadural, Ernani. Postpartum patient engagement mHealth intervention during COVID-19: a mixed methods study. Retrieved from https://doi.org/doi:10.7282/t3-qdzd-jg25

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TitlePostpartum patient engagement mHealth intervention during COVID-19: a mixed methods study
NameSadural, Ernani (author); Zha, Peijia (chair); Chase, Sabrina M (member); Riley, Kristen E (member); Miller, Richard C (member); Rutgers University; Graduate School - Newark
Date Created2022
Other Date2022-05 (degree)
SubjectHealth sciences, Health education, Information technology, COVID-19 pandemic, Health disparities, Maternal mortality, mHealth, Patient engagement, Post birth warning signs
Extent164 pages : illustrations
DescriptionRationale for the study: Maternal morbidity and mortality in the United States continue to be a worsening public health crisis with persistent racial disparities for Black Mothers during the COVID-19 pandemic. Innovations in mobile health (mHealth) technology are being developed as a strategy to prepare mothers for potential post-birth complications by connecting birthing Mothers to their healthcare providers during the critical first six weeks of the postpartum period.Objective: The study explored the preliminary efficacy, feasibility, and experiences with the mHealth intervention by mothers and stakeholders directly involved in the mHealth text-based intervention program.
Methods: A mixed-method triangulation design combined a quasi-experimental study of 12 diverse mothers and a descriptive qualitative study using individual interviews of 13 mothers and seven stakeholders in a large suburban teaching hospital in New Jersey between January and August 2021. Changes in mean postpartum knowledge, self-efficacy, discrimination and postpartum depression were calculated by delta percentage changes. Qualitative data were analyzed by a directed content analysis approach to assess the barriers and factors in implementation.
Results: The intervention group (N=7) had an 84% response rate to text messages. Similar rates of readmission and follow-up at standard six-week postpartum visits were seen in both groups. Intervention feasibility was hampered by technical difficulties resulting in low fidelity of text message enrolment (50%), daily delivery (29%), and processing (68%). The intervention group showed more absolute changes in postpartum knowledge, self-efficacy, discrimination, and postpartum depression than the non-intervention group (N=5). Qualitative data from interviews revealed three major themes: a) Mothers experienced barriers from personal situations at home and with services in the hospital and community that were intensified by the COVID-19 pandemic; b) The COVID-19 pandemic negatively impacted hospital services, priorities, and individual staff; and c) Mothers and stakeholders had positive experiences and perceptions of mHealth intervention.
Conclusions: The socio-ecological framework provided a holistic lens for analyzing the multilevel influences on individual experiences for mHealth intervention. mHealth intervention utilization and reach were influenced by interrelated barriers operating at multiple levels. Recommendations for future implementation viewed through evidence-based models included literacy and language assessment, staff training, hospital and community collaboration, organizational commitment, and feedback from constituents and stakeholders to drive process improvement and delivery of the intervention equitably and effectively.
NotePh.D.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-qdzd-jg25
LanguageEnglish
CollectionGraduate School - Newark Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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