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App-based healthy lifestyle education during pregnancy: Longitudinal effects on mental health in a quasi-experimental
Zahra Alipour1, Mahdieh Naderi2, Zohre Momenimovahed1
1Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
Background:
Perinatal mental health problems are common, but scalable and culturally appropriate interventions remain limited. This study evaluated the effects of an app-based traditional Iranian Medicine-informed healthy lifestyle education intervention on perinatal mental health.
Methods:
In this quasi-experimental study, 72 pregnant women (36 per group) in Qom, Iran, were enrolled in 2025. The intervention group received six app-based educational sessions over two weeks. Mental health was assessed using the 28-item General Health Questionnaire at baseline, three months post-intervention, and 45 days postpartum. Repeated-measures general linear modelling examined time × group effects using outcome-specific complete-case samples with valid scores across all three assessments (n = 65-69).
Findings:
In outcome-specific repeated-measures models, the intervention improved somatic symptoms (p = 0.001, ηp² = 0.119), anxiety/insomnia (p < 0.001, ηp² = 0.141), and the total GHQ-28 score (p < 0.001, ηp² = 0.187), with similar findings after adjustment for maternal education. In the intervention group, total GHQ-28 score improved by 8.47 points at three months and remained 4.78 points below baseline at 45 days postpartum. Anxiety/insomnia improved by 2.78 and 1.94 points, and somatic symptoms by 3.31 and 1.97 points, respectively. At three months, between-group differences favoured the intervention for somatic symptoms, anxiety/insomnia, social dysfunction, and total score; at 45 days postpartum, differences persisted for anxiety/insomnia and total score only. No significant effects were observed for social dysfunction or severe depression.
Conclusion:
App-based Traditional Iranian Medicine-informed healthy lifestyle education improved mental health during pregnancy and early postpartum, with the clearest benefits for anxiety/insomnia, somatic symptoms, and total score. This mHealth intervention may be a feasible adjunct to routine maternal care, although some benefits were reduced after childbirth.
Trial Registration:
Iranian Registry of Clinical Trials (IRCT), IRCT20250423065452N1; retrospectively registered on February 17, 2026.
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