Investigating eHealth lifestyle interventions for vulnerable pregnant women: a scoping review of facilitators and barriers (Preprint)

Abstract

Pregnancy outcomes are positively impacted by maintaining a healthy lifestyle. Some pregnant women are more at risk of having unhealthy lifestyles, due to factors such as a low income or poor living conditions. Pregnant women affected by these vulnerability factors can be supported with eHealth lifestyle interventions that motivate them to make healthier choices. However, there remains a lack of insight into how these interventions are designed, used and implemented, and how they reach vulnerable pregnant women.

This review aims to identify the strategies and considerations employed in the design, reach, use, and implementation phase of eHealth lifestyle interventions for vulnerable pregnant women, and assess whether these factors acted as facilitators or barriers. This review provides valuable insights for future developers of eHealth lifestyle interventions targeting this vulnerable population.We conducted a search on Medline, Embase, Web of Science, Cinahl, Google, and Google Scholar, for studies that described an eHealth intervention for vulnerable pregnant women, focusing on at least one lifestyle component (diet, physical activity, alcohol consumption, smoking, stress or sleep) and provided information on design, reach, use or implementation of the intervention. The abstract screening was done within ASReview.

We conducted a search on Medline, Embase, Web of Science, Cinahl, Google, and Google Scholar, for studies that described an eHealth intervention for vulnerable pregnant women, focusing on at least one lifestyle component (diet, physical activity, alcohol consumption, smoking, stress or sleep) and provided information on design, reach, use or implementation of the intervention. The abstract screening was done within ASReview.

3,904 records were identified, of which 29 met our inclusion criteria. These 29 papers described 20 eHealth lifestyle interventions. Apps were the most frequently used modality for the lifestyle intervention and most studies targeted multiple health behaviors with their intervention. Barriers identified in the design and use phase of these interventions included financial aspects and technological challenges for the target group. Furthermore, barriers were frequently encountered in the reach of vulnerable pregnant women, and included, among others, a lack of interest and time of the target group. Facilitators identified in the design and use phase included collaborating with the target group and other stakeholders (e.g. healthcare providers), leveraging existing eHealth platforms for modifications or extensions, and adhering to guidelines and behavior change frameworks. In addition, tailoring and the use of incentives were identified as potential facilitators. Regarding the interventions’ reach and implementation, collaborating with stakeholders and low labor intensity emerged as facilitators.

This scoping review offers a comprehensive overview of strategies and considerations in eHealth lifestyle interventions for vulnerable pregnant women, highlighting specific barriers and facilitators. Limited reporting on the impact of the employed strategies hinders a complete identification of barriers and facilitators. Nevertheless, this review sheds light on how to optimize the development of eHealth lifestyle interventions for vulnerable pregnant women, ultimately enhancing the health of both future mothers and their offspring.