JMIR Publications

ABSTRACT

Background:

Maternal morbidity and mortality in the United States continue to be a worsening public health crisis with persistent racial disparities for Black women during the COVID-19 pandemic. Innovations in mobile health (mHealth) technology are being developed as a strategy to connect birthing women to their healthcare providers during the first six weeks of the postpartum period.

Objective:

The study explored the experiences with mHealth intervention by mothers and stakeholders who were directly involved in the mHealth intervention program.

Methods:

The qualitative design used GoToMeeting individual interviews of 13 mothers and seven stakeholders at a suburban teaching hospital. Mothers were at least 18 years of age, able to read and write in English or Spanish, had a vaginal or cesarean birth > 20 weeks estimated gestational age, and were admitted for delivery at the hospital with at least a 24-hour postpartum stay. Stakeholders were part of the hospital network’s OB Collaborative sub-committee comprised of administrators, physicians, registered nurses, and informatics. Responses were transcribed verbatim and analyzed for emerging themes. The socio-ecological framework provided a holistic lens for analyzing the multilevel influences on individual experiences.

Results:

Three major themes included: a) Mothers experienced barriers from personal situations at home and with services in the hospital and community that were intensified by the COVID-19 pandemic; b) The COVID-19 pandemic negatively impacted hospital services, priorities, and individual staff; and c) Mothers and stakeholders had positive experiences and perceptions of mHealth intervention.

Conclusions:

mHealth intervention utilization and reach were influenced by interrelated factors operating at multiple levels. Recommendations for future implementation included literacy and language assessment, staff training, hospital and community collaboration, and organizational commitment.