Cultural and Digital Health Literacy of App and Web Based Systems Designed for Pregnant Women with Gestational Diabetes Mellitus: A Scoping Review (Preprint)

Abstract

The prevalence of women diagnosed with gestational diabetes mellitus (GDM) is increasing dramatically. Mobile technologies to enhance patient’s self-management offer many advantages for women diagnosed with GDM. However, to our knowledge while mHealth and telemedicine systems for GDM management exist, the evidence on their cultural appropriateness and digital health literacy levels is limited.

The aim of our review was to search the literature on mobile health (mHealth) and telemedicine systems designed for women diagnosed with GDM and assess for cultural appropriateness and digital health literacy as well as systems’ effectiveness in improving glycemic control, and maternal and infant outcomes.

We conducted a scoping review using the framework adapted from Arksey and O’Malley. Four electronic databases were searched between January 2010 and January 2022. We used terms related to mobile apps and telemedicine, GDM, vulnerable populations, periphery, cultural appropriateness, and digital health literacy. Studies were screened and selected independently by two authors. We extracted the studies data on an Excel charting table and categorized it for final themes.

We identified 17 studies that reported on twelve telemedicine and mHealth apps interventions. We assessed the studies in 3 domains (1) cultural appropriateness (2) digital health literacy and (3) maternal and infant outcomes. Considerations in app design regarding cultural appropriateness were found only in two studies and only three interventions scored 3 or above out of a score of 5 in our assessment of digital health literacy.

mHealth and telemedicine can be an effective platform to improve clinical management of women with GDM. Although studies published on the use of mHealth and telemedicine systems exist, there is limited body of knowledge on the digital health literacy and cultural appropriateness of the systems designed for women diagnosed with GDM. Further research is needed to evaluate the effectiveness of tailored apps for enhancing pregnant women’s self-management as well as their effectiveness in improving maternal and infants’ health outcomes.

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