Skip to main content

Table 3 Themes and Subthemes from Focus Groups regarding Content, Functionality, and Future Prospective of SmartMoms Canada

From: Development and pilot evaluation of a pregnancy-specific mobile health tool: a qualitative investigation of SmartMoms Canada

Thematic Analysis

Supportive Evidence

1. Strengths of the SmartMoms app

Pregnancy guidance and support

“I definitely think that for people who haven’t necessarily tried a whole bunch of fitness apps or haven’t tried other pregnancy apps, it’s a fantastic place to start. Because it’s a tool, and when you’re pregnant any tool [is] helpful because it answers your questions and it helps you lower your stress level and having some guidance is wonderful.”

“I think a lot of people [would] rather turn to apps in pregnancy because it gives them that informal support that their OB or their midwife may not have time to offer them, or they may not feel comfortable asking questions…and it can be a real asset.”

“I thought it was helpful to have…small pockets of information”

Pregnancy-specific exercises

“All the exercises…were great.”

“I didn’t always read the entire text [associated with exercises], because the visual was a pretty good reminder.”

“I definitely like that you can see the image of the [pregnant] person”

Synchronization with ©Fitbit

“I never had a ©Fitbit before and really being mindful about how much I’m walking…if it had [synched] would’ve been more interesting.”

Advice on sleep

“I found them [SmartTips] helpful in general, especially sleep is really interesting, because it’s not something I prioritize or think of at the forefront of health, but it [SmartMoms] kind of explains that when you’re not sleeping enough you’re probably going to eat more, and [this] can be linked to gestational diabetes, so [it] is interesting…I found it was good and made me more well-rounded when it comes to health”

2. Critique of the SmartMoms app

Design and aesthetic

“I think part of it is that in a lot of apps you get some visual to cue you to touch things and here because everything was kind of [in] squares…you didn’t have that same visual cues.”

“I find other apps [have]…really bright colours, there’s things that are standing out, whereas this [SmartMoms] is a little more muted.”

Interactivity

“I find something big with [SmartMoms] is there’s no real interactivity…it says, “set goals” but you can’t put a goal in, and it says this is a checklist of things to do but you can’t check off these are things I’ve done.”

Feedback

“I think part of it is…it [SmartMoms] kept saying you’re underweight…so [now] what should I be eating that’s healthy?...what’s the next recommendation? I think that little bit of [information on] how to eat more healthy so that I could be in the healthier range would have been… more helpful.”

Emphasis on weight gain

“I do find the emphasis on the app, on the weight gain like I would have preferred more on the physical activity [such as] these are things good for your hips at this stage; your body is changing in this way so focus on these stretches.”

Developmental and technical issues

“My weight would change 15 lbs depending on where I was taking my weight in my apartment. But it [©BodyTrace scale] was just not synching with the app. So, I did not use it as much as perhaps I should.”

“I found every time I’d go to settings that’s when it would crash.”

3. Knowledge of Pregnancy-Specific mHealth Services

Technologically proficient group that interacted with several mHealth tools

“I used the BabyCentre app. It doesn’t have any of the health tracking, but it does have a lot of good articles and forums to talk to other moms. [BabyCentre] has updates on where you are in the pregnancy.”

“…I started using Ovia because a friend of mine who was pregnant last year recommended it to me…and that app [Ovia] in particular helped replace a lot of the heavily been googled forums of “Is this normal?!”

4. Knowledge and Attitudes of Weight Gain Guidelines

Strong familiarity of evidence-based guidelines

“I think we might be a very educated group, but other people aren’t aware of that [IOM guidelines] and they’re still on that perspective that oh I can eat for two”

Negative views of guidelines

“I think move away from the numbers and just more education about the concept of healthy weight gain and then healthy eating”

Positive views of guidelines

“I think the guidelines are good, but I think it’s important to remember that they’re guidelines.”

“I think it’s important that people know [the guidelines] but there’s a fine line between having people stressed about [them] and being aware that just because they’re pregnant doesn’t give them free range to gain as much weight as they can”

5. Weight Tracking

Feedback on weight from HCP

“I was weighed at all my appointments, but I think my doctor would have raised it [weight measured] had it been a concern. These appointments are quick – okay, everything is good, okay, bye…do you have any questions and if I don’t have any questions then… I feel like the OB/GYN are really busy and …I found that they were really quick appointments and there wasn’t any concerns then there was nothing raised unless I had questions and in terms of me weighing myself at home, yes I would once in a while mainly just because I was curious.”

“I was followed by my GP up until 16 weeks and then referred but he never mentioned healthy weight gain or what to expect. He weighed me every time, but I think similarly he would have said something if there was something to worry about.”

Worry and stress associated with daily weight tracking

“I don’t like to weigh myself daily because it makes me really anxious and I’m thinking any person with an eating disorder, weighing yourself daily is not good. So maybe just a…reminder once a week might be enough.”

Weight tracking positively viewed

“I’ve always weighed myself, once a week or once every two weeks. When I got pregnant I was on the cusp of BMI of overweight, so it was something that I was concerned about, because I don’t want to gain too much. But, having the app…I wanted to test it a lot, I did usually weigh myself every day…but I would go back to weighing myself probably once a week.”

6. Future Suggestions for SmartMoms Canada

Greater focus on overall maternal health

“…if you have a baby section maybe have a “what’s going on with your body this week” because for a lot us who are first pregnancies, I thought it’s been a sharp learning curve”

“I think more focus on the exercise, more focus on the healthy eating, healthy sleeping…[and] water intake. Weight is part of it [health] but…the other things are more important.”

“…I would have liked more of a healthy mind component as well.”

Incorporate exercise routines based on time, availability, and trimester

“Have mini workouts instead of just pick random exercises”

“Maybe when [SmartMoms] explains our routine, something is already built but that could change throughout the pregnancy. Because what you can do in your first semester is not what you can do in your third semester.”

“It would be nice to say how much time do I have? And you can have 5 min, 10 min [and then] pick something [or] try this? That sort of thing really engages you.”

Reassuring feedback and enhanced interactivity

“Yeah! Some feedback would be good, reassuring.”

“I’d like if it [SmartMoms] had notifications like “remember to do this today” or exercise plans…okay, I have a plan, I can do this! Instead of, “well, what am I going to do today?”

Organize app content based on personal health preferences

“I think it [SmartMoms] could just be visualized based on your health priorities. So, like you said like if you don’t want to see weight maybe it [can] go to the bottom of your dashboard or maybe it’s something you can hide completely. If you’re more focused on making sure you get your greens or your activity, then maybe that could be raised a little higher.”

Connecting with other pregnant women, using forums, discussion boards, and blogs

“…on websites there are always discussion boards or a blog you kind of hear from other moms and what they’ve tried….with the app, it’s okay, it’s just what you should do…It’s always nice to get different opinions and what worked a little bit easier for someone and what worked better for someone else.”

“Maybe it [SmartMoms] could even have a social aspect where you could link with other moms within the radius who have the app.”