Purpose: To assess the feasibility of the Two Happy Hearts (THH) technology-based self-management model for improving perinatal health. The THH is a home-based stress-reduction intervention that promotes the health and well-being of both mother and infant.

Background/significance: During pregnancy, women experience several physical and psychological changes that affect their quality of life. Moreover, maternal stress has been found to be associated with poor birth outcomes, including low birth weight, pre-term birth, and neurodevelopmental disorders, all of which may have long-term health consequences in childhood, extending into adulthood. Personalized health management interventions, in addition to social support, are effective strategies for alleviating stress during pregnancy. Particularly, the increasingly widespread adoption of modern health technology such as mobile health (mHealth) and telehealth comprise methods to ensure equitable access to adequate and timely resources for at-risk pregnant women. Not only are these technological approaches cost-effective methods with the potential to reduce national health expenditure, but they also increase health equity by improving access to quality care for underserved women who may otherwise be excluded from essential health services. The Two Happy Hearts (THH) technology-based self-management model proposes to address these gaps.

Methods: In line with the goal of increasing health equity across at-risk socio-economic and demographic groups, this feasibility study is designed to assess the THH theory-driven model. The sample is composed of at-risk adult women with a singleton pregnancy who have access to a smartphone. This research model integrates mHealth and telehealth to collect objective and subjective physical and mental health data throughout pregnancy. Using the THH mHealth in the form of smartphone-based surveys and wearable devices (smartwatch and ring), pregnant women are empowered to monitor their emotional states, stressors, sleep, steps, and heart rate. This app-based intervention includes mindful breathing and safe exercise routines, all of which have been carefully developed by experts in line with the American College of Obstetricians and Gynecologists guidelines. Particularly, the triage system incorporated into the mHealth application captures high-risk mental health concerns for timely response. In addition, telehealth is delivered virtually by trained community health workers (CHWs) who provide health education and guide women through personalized coaching, compassionate listening, and social support.

Results: Preliminary data from the ongoing feasibility study indicate successful recruitment of at-risk pregnant women who often wear the smartwatch and ring. Completion of the smartphone-based surveys provides evidence about the acceptability of mHealth. In addition, women are motivated to track their emotional states, stressors, sleep, steps, and heart rate to practice appropriate coping strategies on a regular basis and when needed. Similarly, pregnant women have expressed positive experiences with the virtual visits and health coaching by the CHWs. Thus far, attrition rates are very low.

Conclusions/implications: The THH technology-based model endeavors to promote self-management of mental and physical health for vulnerable pregnant women by providing personalized health education and support. We anticipate that results generated from this research study will ultimately increase health equity and improve the quality of maternal and infant care.

Leaning Outcome:
After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

Tamara Jimah PhD

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