SmartMom Text Messaging for Prenatal Education: A Qualitative Focus Group Study to Explore Canadian Women's Perceptions

Sarah Munro; Amber Hui; Vanessa Salmons; Carolyn Solomon; Emily Gemmell; Nahal Torabi; Patricia A Janssen

doi:10.2196/publichealth.6949

SmartMom Text Messaging for Prenatal Education: A Qualitative Focus Group Study to Explore Canadian Women's Perceptions

JMIR Public Health Surveill. 2017 Feb 7;3(1):e7. doi: 10.2196/publichealth.6949.

Authors

Sarah Munro^{1

2}, Amber Hui³, Vanessa Salmons⁴, Carolyn Solomon⁵, Emily Gemmell³, Nahal Torabi⁶, Patricia A Janssen³

Affiliations

¹ Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
² The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States.
³ School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁴ Maternal, Infant, Child and Youth, Public Health, Northern Health Authority, Quesnel, BC, Canada.
⁵ Maternal and Women's Health, Public Health Services Branch, Population and Public Health Division, British Columbia Ministry of Health, Victoria, BC, Canada.
⁶ Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.

Abstract

Background: We engaged Canadian women in the development of a prenatal education program delivered via one-way text messaging called SmartMom. SmartMom is the first peer-reviewed, evidence-based mHealth program for prenatal education in Canada and the first to be endorsed by the Society of Obstetricians and Gynaecologists of Canada.

Objective: To explore women's preferences for a prenatal education program by text messaging.

Methods: We conducted a qualitative focus group study in three Canadian communities in the Northern Health Authority. Women completed a demographic questionnaire, participated in a guided discussion about their pregnancy information-seeking behavior, reviewed a printed copy of the SmartMom text messages, and then engaged in a moderated discussion about their perceptions of the usability of the SmartMom program. Open-ended questions explored women's perceptions regarding the message content, acceptability of receiving information by text message, positive health behaviors they might engage in after receiving a message, modifiable program factors, and intention to use the program. Thematic analysis of transcribed audio recordings was undertaken and modifications were made to the SmartMom program based on these findings.

Results: A total of 40 women participated in seven focus groups in three rural northern communities. The vast majority had a mobile phone (39/40, 98%), used text messages "all the time" (28/40, 70%), and surfed the Internet on their phone (37/40, 93%). Participants perceived SmartMom to be highly acceptable and relevant. The text message modality reflected how participants currently sought pregnancy-related information and provided them with local information tailored to their gestational age, which they had not received through other pregnancy resources. Women recommended adding the opportunity to receive supplemental streams of messages tailored to their individual needs, for example, depression, pregnancy after previous cesarean, >35 years of age, new immigrants, and harm reduction for smoking and alcohol.

Conclusions: This formative qualitative evaluation provides evidence that a prenatal education program by text messaging, SmartMom, is acceptable to the end users. These findings support the usability of the SmartMom program at a population level and the development of an evaluation program exploring the effects of the text messages on adoption of health-promoting behaviors and maternal-child health outcomes.

Keywords: health behavior; pregnancy; prenatal education; text messaging.

©Sarah Munro, Amber Hui, Vanessa Salmons, Carolyn Solomon, Emily Gemmell, Nahal Torabi, Patricia A Janssen. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 07.02.2017.