Hans van den Heuvel

Theme 1: Expectations of and Satisfaction With the mHealth Technology Quantitative Analysis Analysis of the usability questionnaire showed that almost all participants (49/51, 96%) felt comfortable using mHealth. The vast majority (45/51, 88%) would recommend it to their friends and family, especially participants who had been pregnant before (97% of multiparous vs. 74% of nulliparous women). Overall, client-centeredness of the blended care approach, based on the CCCQ, was rated at an average 57.5 of 75 points (range 36-75 points), which translates to a score of 77 from a possible total score of 100. This total CCCQ score was comparable between nulliparous women (score of 76, n=19) and parous women (score of 77, n=33). Of all parous women, women with prior HDP (19/33) scored the CCCQ slightly higher (score of 79/100) than those without experience with HDP (14/51; 75/100). Qualitative Analysis In order to understand what is important for mHealth users, we asked the interview participants what their expectations were before they started using the digital technology in the Safe@Home study and whether their expectations were met. The most often mentioned motivations to start using the technology were the expected reassurance of being closely monitored by a health care professional (9/11; 2 nulliparous and 7 parous), better pregnancy outcomes (6/11; 3 with a history of hypertension and 3 with a history of HPD), and the prospect of fewer hospital visits (5/11; none with a history of HPD). This aligned well with their experiences; most interview participants (8/11) reported they felt reassured and safe because of the close monitoring by their obstetric care professional. The use of mHealth reduced the frequency of visits, which contributed to the users’ wellbeing and a more relaxed pregnancy experience (9/11; 2 nulliparous and 7 parous). The blended care approach also enabled timely preventative measures or interventions, which resulted in early detection of abnormalities or risks (2/11). All interview participants considered it a benefit to be able to measure their own blood pressure, especially when they experienced symptoms associated with preeclampsia. Table 2. Quotes illustrating interviewees’ expectations and satisfaction. Topic Quotes Reassurance More relaxed, I’d say. I haven’t worried at all about my blood pressure. I considered it under control […] Because you do it continuously [the measurements], it reassures you. (P1) It is very pleasant and extremely easy. It’s reassuring that you are being monitored [by health care professionals]. (P11) Frequency of visits It has given me peace of mind over all those months, primarily because of the significantly reduced number of clinical visits. (P1) It is ironic; we expected it because it was announced like that, that we would have to visit the hospital less often, because we would be monitored via the app, but it resulted in more frequent contact. (P5) CHAPTER 7 108