Hans van den Heuvel

A few users mentioned that measuring early in the morning was not always easy to combine with either commuting to work or “family rush hour” in the morning (3/11) or not representative, as their morning blood pressure was naturally low (1/11). These users preferred to have the option to measure in the evening instead of the morning. Most considered measuring 5 times a week sufficient; a couple of interview participants measured every day, even during weekends, either because of worries about her medical condition (1/11; with a history of HPD) or to allow it to become a habit in their daily routine (2/11). Multiple mHealth users (4/11) measured several times a day when they experienced symptoms of preeclampsia or hypertension. At the same time, others (6/11; 4 with a history of HDP) mentioned that daily measurements were too burdensome or medicalizing, especially when they perceived their symptoms or blood pressure to be stable. A couple of interviewees (2/11) mentioned they missed the mHealth tool after giving birth and would have wanted to continue to measure during their postpartum period. A couple of women (2/11) mentioned technical errors in the synchronization of their measurements with the system used in the hospital. Furthermore, a couple of others (2/11; both parous and with a history of hypertension) felt that the symptom score list to monitor preeclampsia signs was at times confusing because some questions did not match the specific pregnancy term. In particular, the question “Can you feel the baby move?” was considered to be upsetting in the first trimester. Also, one interview participants considered the orange or red lights stressful, as she never saw a green light because of her high values (P9, with a history of HPD; Table 3). Table 3. Quotes illustrating interviewee perspectives on the usability of the mHealth tool. Topic Quotes App vs web portal At first, I used the web portal, but when I had a closer look, I realized that the app is much easier, because it automatically synchronizes. It is so easy! (P1) Frequency of measurement Before I started, I thought it would be burdensome to measure my blood pressure every day and was not convinced that it would be necessary. [...] But eventually, it was very easy. It became part of my routine to measure in the morning before going to work or before bringing the children to school. (P8) The app was meant to be used in the morning, which was somewhat a downside, because my blood pressure is fine in the morning. (P3) While I was using it, no [I did not experience anything unexpected], but after giving birth and being back home, I continued measuring with my own device, because I missed that sort of information about my body. (P7) Questions suitable to term Those questions did not really match with being in the first trimester. Because it asked for example “do you feel contractions,” “do you still feel the baby move,” But [at that time], I hardly had a belly, and I couldn’t even feel the baby yet. [..] I found it difficult and puzzling. (P10) Alarms “Those lights [on the blood pressure device], they should get rid of in favor of people who are easily stressed out. It showed orange so often. Since my blood pressure has been high my whole life, you feel like there is a continuous alarm, while yeah, that was not really the case.” (P9) CHAPTER 7 110