Towards effective digital lifestyle interventions for pregnant women with obesity
A qualitative study exploring women's and healthcare providers’ perspectives
Rianne J. de Bruin (Erasmus MC)
Caroline A. Figueroa (TU Delft - Information and Communication Technology)
Pam ten Broeke (Universiteit Leiden)
Kim N. de Jonge (TU Delft - Information and Communication Technology)
Melek Rousian (Erasmus MC)
Régine PM Steegers-Theunissen (Erasmus MC)
Ageeth N. Rosman (Rotterdam University of Applied Sciences, Erasmus MC)
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Abstract
Background: Maternal obesity increases risks of adverse pregnancy outcomes and long-term diseases for mothers and child. Digital lifestyle interventions show promise, but their effectiveness depends on meeting the specific needs of pregnant women with obesity and healthcare providers (HCPs). Objectives: To explore perspectives and practices on healthy lifestyle and care for pregnant women with obesity, and to identify needs and preferences for digital lifestyle intervention development and implementation. Methods: A qualitative study using focus groups and interviews was conducted with 13 HCPs and 13 pregnant women with obesity. Sessions were audio-recorded, transcribed and analysed thematically. Women viewed a healthy lifestyle as multidimensional, encompassing nutrition, physical activity, mental well-being, and rest, but faced barriers such as pregnancy discomfort, limited knowledge, and stigma. Both women and HCPs emphasized child health as a motivator and valued goal setting and practical advice. Existing care was seen as inconsistent and generic, with HCPs constrained by time and unclear roles. Participants preferred a personalized, user-friendly mobile app with modular, evidence-based content tailored to individual goals, pregnancy stage, and medical status. Features such as self-monitoring, goal setting, and a supportive, non-judgmental tone were important. Integration into routine obstetric care was considered key for engagement and effectiveness. If designed accordingly, such tools could provide accessible, tailored support between appointments, reinforce positive behaviour change, improve patient-provider communication, and reduce HCP time pressures. Conclusions: Co-designing digital lifestyle tools with women and HCPs is vital. Personalized, feasible interventions integrated in obstetric care can support behaviour change and improve outcomes for mothers and children. Trial registration number: not applicable.
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