Personalization and localization as key user expectations of digital health intervention for women before, during and after pregnancy: A qualitative study

Objective Health behaviors before, during and after pregnancy can have lasting effects on maternal and infant health outcomes. Although a digital health intervention (DHI) has potential as a pertinent avenue to deliver mechanisms for a healthy behavior change, its success is reliant on addressing the user needs, without creating apprehension that may lead to attrition. Accordingly, the current study aimed to understand DHI needs and expectations of women before, during and after pregnancy to inform and optimize future DHI developments, specifically ‘the do’s and the don’ts’ for sustainable engagement and efficient intervention. Methods Forty-four women (13 pre-, 16 during and 15 post-pregnancy; age range = 21–40 years) completed a 60-minute, semi-structured, qualitative interview exploring participant’s experience in their current phase, experience with, and attitude towards digital health tools, and their needs and expectations of DHIs. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. Results From the interviews, two core concepts emerged – personalized journey and embedding within the local ecosystem. Between both concepts, five themes and 12 sub-themes were identified. Themes and sub-themes within personalization cover ideas of two-way interactivity, journey organization based on phases and circumstances, and privacy trade-off. Themes and sub-themes within localization cover ideas of access to local health-related resources and information, and connecting to local communities through anecdotal stories. Conclusion The findings captured - through understanding user needs and expectations - the key elements for the development and optimization of a successful DHI for women before, during and after pregnancy. To potentially empower downstream DHI implementation and adoption, these insights can serve as a foundation in the initial innovation process for DHI developers and be further built upon through a continued co-design process.