Behavior Change Apps for Gestational Diabetes Management: Design and evaluation of desirable features (Preprint)

BACKGROUND Gestational diabetes mellitus (GDM) has considerable and increasing health effects as it raises both the mother’s and offspring’s risk for short- and long-term health problems. GDM can usually be treated with a healthier lifestyle, such as appropriate dietary modifications and engaging insufficient physical activity. While telemedicine interventions requiring weekly or more frequent feedback from health care professionals have shown the potential to improve glycemic control amongst women with GDM, apps without extensive input from health care professionals are limited and have not shown to be effective. The desirable features for increasing the efficacy of GDM apps has been proposed in previous work, but investigations on how they should be designed are lacking. OBJECTIVE We aimed to improve the efficacy of GDM self-management apps by designing and evaluating desirable features. METHODS We provided example implementations of the desirable features in an interactive prototype app and requested feedback from women with GDM in semi-structured interviews. RESULTS The feedback on the interactive prototype supported the need for desirable features and provided new insights on how the features should be incorporated into GDM apps. In addition, we found two additional themes. First, basic functionalities that are fast to learn by women with GDM who have recently received the diagnosis should be provided but there should be also deeper features to maintain interest for women with GDM at the later stage of pregnancy. Second, as women with GDM may have feelings of guilt, the app should have a tolerance and supporting approach for unfavorable behavior. CONCLUSIONS We provide constructive suggestions on how desirable features can be incorporated in future GDM apps. We expect that following the proposed designs will increase the efficacy of GDM self-management apps. CLINICALTRIAL ClinicalTrials.gov NCT03941652