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Understanding Symptom Self-Monitoring Needs Among Postpartum Black Patients: Qualitative Interview Study.

Natalie Benda1, Sydney Woode2, Stephanie Niño de Rivera1

  • 1School of Nursing, Columbia University, New York, NY, United States.

Journal of Medical Internet Research
|April 26, 2024
PubMed
Summary

Black patients need patient-centered mobile health (mHealth) tools for postpartum symptom monitoring. These systems should capture somatic and psychological symptoms, considering individual factors and providing clear, reassuring guidance for seeking care.

Keywords:
Blackdeathdecision supportdesign needethnichealth equityinformation needinformational needmHealthmaternalmaternal mortalitymaternitymental healthmobile healthmobile phonemortalityobstetricobstetricspatient-reported outcomepatient-reported outcomespostnatalpostpartumqualitativequalitative researchwomen’s health

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Area of Science:

  • Perinatal Health
  • Digital Health
  • Health Disparities

Background:

  • Pregnancy-related deaths are increasing in the U.S., with higher mortality rates among Black patients.
  • Existing hospital-based solutions for pregnancy-related death are insufficient due to reported bias in healthcare systems.
  • There is a critical need for patient-centered interventions that empower postpartum individuals to seek timely care for severe symptoms.

Purpose of the Study:

  • To determine design requirements for a mobile health (mHealth) patient-reported outcomes and decision-support system.
  • To assist Black patients in identifying when to seek medical care for severe postpartum symptoms.
  • To inform potential applications for other minoritized perinatal populations.

Main Methods:

  • Conducted semistructured interviews with 36 participants, including obstetric and mental health professionals, and postpartum Black patients.
  • Investigated current symptom monitoring practices, barriers, facilitators, and mHealth system design needs.
  • Analyzed interview transcripts using directed content analysis and thematic analysis with multiple coders for reliability.

Main Results:

  • Participants emphasized the importance of capturing both somatic and psychological symptoms.
  • Patient symptom processing and decision-making are influenced by self-perception, experience, and sociocultural, financial, environmental, and health system factors.
  • Recommended mHealth system designs include user control, freedom, and carefully worded decision-support messages to convey urgency without anxiety.

Conclusions:

  • Future postpartum symptom monitoring solutions must integrate somatic and psychological symptoms.
  • mHealth interventions should offer safe, varied interactions tailored to individual needs.
  • These tools can provide crucial information and resource navigation for patients, addressing some social and financial needs indirectly.