Hans van den Heuvel

Interviews Semistructured in-depth interviews were conducted with participants of the overarching study after an email invitation. Patients who were willing to be interviewed and were able to speak either Dutch or English were included in the interview study through purposive sampling.Thetopiclistwasdesignedtoincludethemotivations,experiences,andperspectives of patients using the platform. The semistructured format provided participants with the opportunity to discuss matters they believed needed emphasis, while offering guidance throughout the interview. Questions for the interview guide were based on preliminary quantitative results from our questionnaires, which suggested the importance of technical functioning, communication with care providers, and implications for autonomy. The topic list was expanded based on the literature on ethical aspects of digital health, mHealth, and digital monitoring. Interviews were conducted by KJ (assistant professor) and MD (research assistant), both female researchers with experience in qualitative studies using interviews. No relationship with participants was established prior to the interviews. The interviews were conducted until saturation was reached, meaning that no new perspectives or themes were found in consecutive interviews and no new themes emerged from the data. Verbatim transcriptions of interviews and interviewers’ notes were compared with audio recordings to check for accuracy. Transcripts were imported into NVivo12 and analyzed thematically, combining inductiveanddeductiveanalyses. KJ andMDstartedwithanapriori coding scheme to allow for deductive coding based on topics described in the literature (responsibilities, shared decision making, patient empowerment, motivations). Codes and their meanings were discussed among the research team prior to coding to guarantee intercoder reliability. The inductive part of the thematic analysis combined methods of close reading and constant comparison; codes emerging from the transcripts were clinical expertise, reassurance, burden and stress, and understanding one’s own condition. Codes were examined and systematically reviewed for supporting or conflicting evidence concerning emerging themes and codes. We also explored whether there were any differences between nulliparous and parous women and between women with a history of HDP and those without. Where relevant, we explicitly address these differences in the results. Results are reported using the Consolidated Criteria for Reporting Qualitative research checklist. RESULTS Patient Characteristics Of 103 invited participants, a total of 51 participants completed both questionnaires, and one participant only completed the CCCQ (total n=52). The interviews were conducted with 11 women (8 after delivery, 3 during pregnancy) and comprised the qualitative part of this study. All interviews (n=11) took place by phone, as preferred by the participants, and lasted between 35 minutes and 58 minutes. The majority of the interviewed women (8/11) also completed the questionnaires. CHAPTER 7 106