Participant evaluation of MOMitor™-a smartphone-based application that monitors postpartum mental and physical health...

MOMitor™ is a mobile app using ecological momentary assessment (EMA) developed and piloted in a large, quaternary care health-system. The purpose of MOMitor™ app is to monitor real-time mood, cesarean incision for symptoms of infection, hypertension, and diabetes in postpartum women. The MOMitor™ triggers alerts for clinic staff when predetermined thresholds are crossed based on survey responses. This prompts nurse-led follow-up and necessary clinical actions. This study aims to analyze exit surveys from all MOMitor™ participants at the end of the 6-week postpartum intervention during the app's 1-year beta testing phase. The objectives of this multi-method study were to explore the user (postpartum women's) satisfaction with the MOMitor™ app, perceived benefit, and challenges encountered during the use.

We enrolled 535 women in a 6-week study using the MOMitor™ app, which involved downloading and using the app postpartum. Participants received an exit survey via email, with reminders, and completed it electronically through research electronic data capture (REDCap). The survey included multiple-choice and open-ended questions to assess user (postpartum women's) experience, app utility, and suggested improvements. Responses were collected electronically through REDCap; statistical analysis was performed using SAS version 9.4 to examine the association between monitored conditions and app compliance and usefulness. Content analysis of open-ended responses identified themes of satisfaction and challenges with the app, providing valuable insights into user (postpartum women's) experience and app functionality.

The overall response rate to the exit survey was 49.4%. A total of 190/535 participants reported opening the app. 91.4% of participants who opened the app reported receiving 38 notifications, and 84% completing assessments most or every time. A significant proportion of respondents also utilized mood tracking (75%), nurse contact (46.9%), and clinician discussions (21.9%). The qualitative data showed that the benefits of the MOMitor™ app as its ability to give support in symptom monitoring, ease of reaching clinicians when needed, helpful notifications for task reminders, and the convenience of having an easy-to-use app always accessible on their phones. Further, challenges with the MOMitor™ apps were unfriendly interface, short response times, frequent update requirements, the need to keep the app open in the background, and a visually unappealing design.

This feasibility study indicates that mobile apps like MOMitor™, using EMA, can be a useful tool for monitoring postpartum women's health, but may not be universally adopted due to varying levels of engagement and participation. Enhanced patient-clinician communication and self-monitoring benefits of MOMitor™ were valued and accepted by the participants.