Trial lecture title: Future welfare technology solutions in maternity care in a multicultural context – opportunities and challenges.
Ordinary opponents:
- First opponent: Professor Christine Rubertsson, Lund University, Midwifery Research – reproductive, perinatal and sexual health, Sweden
- Second opponent: Associate Professor Annsofie Adolfsson, School of Health Sciences, Örebro University Sweden
- Leader of the evaluation committee: Associate Professor Anne-Kari Johannessen, Faculty of Health Sciences, OsloMet
The leader of the public defense is Professor Sølvi Helseth, Vice-Dean R&D, OsloMet.
The main supervisor is Professor Mirjam Lukasse, Faculty of Health Sciences, OsloMet.
The co-supervisors are Associate Professor Lisa Garnweidner-Holme, Faculty of Health Sciences, OsloMet and Professor II Anne Flem Jacobsen, Faculty of Medicine, University of Oslo.
Abstract
Gestational diabetes mellitus (GDM) is glucose intolerance first identified during pregnancy. Pregnant women with GDM are more likely to develop preeclampsia, to have a caesarean section, and develop type 2 diabetes mellitus and their children are more likely to be macrosome, have a shoulder dystocia and to develop diabetes.
A healthy diet, physical activity and measuring of blood glucose values are important treatment of GDM. Health information through an app that automatically transfers blood glucose measurements provides an easy monitoring.
Aim
To develop the Pregnant+ app for women with GDM to encourage a healthy diet, physical activity and regular measurement of blood glucose. Investigate knowledge of GDM and study the effect of the Pregnant+ app on the oral glucose tolerance test (OGTT) postpartum.
Materials and method
The Pregnant+ app was developed by an interdisciplinary team. Qualitative interviews and user involvement were performed. The Pregnant+ study included pregnant women attending five diabetes outpatient clinics.
The women were recruited before 33 weeks of gestation, they needed a smartphone and had to speak Norwegian, Urdu or Somali. The women answered one questionnaire at recruitment and one postpartum.
The questionnaires contained several validated instruments and questions about GDM knowledge. After the randomisation, one group was given access to the Pregnant+ app and usual care and the other group received usual care only. The main outcome was the OGTT levels three months postpartum.
Results
The user involvement in the development of the Pregnant+ app was important. The consequences of GDM was enhanced, pictures included and smileys gave feedback on the blood glucose values. Knowledge of GDM was poorer among non-Norwegian speakers.
The Pregnant+ app had no effect on the OGTT postpartum. Women’s self-reported engagement in their own health was significantly higher in the group with access to the Pregnant+ app compared to the control group.
Conclusion
It is important to have user involvement and a multidisciplinary team when developing apps for women with GDM. The app must be easy to use, culturally adjusted and in line with the information given by health workers. Women who did not speak Norwegian as their mother tongue had limited knowledge about GDM. Apps may influence women’s engagement in their own health and might be a useful tool in managing GDM.
