Feasibility and Usability of a Digital Perinatal Navigator for High-Risk Pregnancies: Mixed Methods Study

The journey to parenthood involves significant physical, emotional, and psychosocial changes. Mental health challenges impact both maternal and fetal health, potentially leading to obstetric complications and developmental risks for children. Access to needed perinatal support is often limited due to individual and structural barriers. Digital health solutions can offer opportunities to provide low-threshold, personalized, and scalable support. We developed a digital navigator offering personalized guidance and connecting users to relevant support services with interactive follow-ups to self-assess their well-being. However, evidence regarding the feasibility of digital solutions in high-risk patients is limited.

This study aimed to assess the feasibility and usability of a digital perinatal navigator app designed to provide personalized support and connect individuals with high-risk pregnancies to relevant health and social services.

Conducted at University Women's Hospital Heidelberg, the study used convenience sampling for a 2-week app test phase. A convergent mixed methods design integrated qualitative interviews (n=30) with psychometric surveys (n=35). Analyses included thematic analysis of interviews, descriptive statistics, 2-tailed paired t tests, and Pearson correlations. Results were triangulated at the end to better understand barriers to use.

Participants (median age 33 years; median gestational age 30 weeks) reported moderate to high rates of stress, anxiety, and depressive symptoms. Usability ratings were excellent (median System Usability Scale [SUS] score 80, IQR 17.5; median mHealth App Usability Questionnaire [MAUQ] score 111, IQR 28). Knowledge of health service providers increased significantly (mean +1.2 points; P<.01), with modest improvements in use. Qualitative analysis revealed key success factors such as intuitive structure, trustworthy medical content, and personalized information. Technical disruptions, navigation challenges, limited personalization, and incomplete regional integration of health care services were reported as barriers.

The results indicate high feasibility and usability for our digital navigator in this high-risk population. The identified barriers are to be considered in the further development of the app and other perinatal digital care programs.