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  1. Article ; Online: Digital Health Needs and Preferences During Pregnancy and the Postpartum Period: Mixed Methods Study.

    Henrich, Natalie / Brinson, Alison / Arnold, Alyssa / Jahnke, Hannah R

    JMIR formative research

    2024  Volume 8, Page(s) e48960

    Abstract: Background: Digital health is increasingly used to meet the needs of perinatal people, with estimates of pregnancy-related internet use ranging from 90% to 97% of pregnant people. As digital health takes on greater importance during the perinatal period, ...

    Abstract Background: Digital health is increasingly used to meet the needs of perinatal people, with estimates of pregnancy-related internet use ranging from 90% to 97% of pregnant people. As digital health takes on greater importance during the perinatal period, it is essential that providers and developers of digital health content understand why perinatal people use these resources and the features that enhance their experience. However, gaps remain in understanding the content that is most helpful and how the platforms are navigated. Learning directly from perinatal people about their needs will help ensure alignment between perinatal needs and available content.
    Objective: This formative study aims to identify the reasons why perinatal people use digital health resources; the features of the digital health platforms that are of greatest importance to them; and how these differ by perinatal stage (pregnancy vs post partum), mental health conditions, parity, and demographics (race and ethnicity).
    Methods: This mixed methods study used interviews; surveys; and secondary data on demographic, health, and pregnancy characteristics to identify the digital health needs and preferences of pregnant and postpartum people who used the Maven digital health platform in the United States during their pregnancy or postpartum period. The interviews informed the content of the surveys and provided additional insights and examples for interpreting the survey results. The surveys were used to collect data from a sample of Maven users, and the results were linked to the secondary data set. The interviews were thematically analyzed, and survey data were analyzed using descriptive statistics and stratified by parity, race, and mental health status.
    Results: Overall, 13 people were interviewed (including n=4, 31% pilot interviews), and 147 pregnancy and 110 postpartum survey respondents completed the surveys and had linkable secondary data. Top reasons for using digital health resources during pregnancy were to (1) know what is normal or typical during pregnancy, (2) have access to a health care provider when needed, and (3) know how the baby is developing. Top reasons for postpartum use were to (1) help with breastfeeding, (2) know what normal baby development is, and (3) help with the baby's health issues. Top platform features during pregnancy and the postpartum period were (1) credible and trustworthy information and providers, (2) nonjudgmental information and support, and (3) no cost to the user. In general, more reasons for using digital resources were identified as extremely important during pregnancy compared with post partum. The results showed minor variations across strata.
    Conclusions: This formative research found minor differences in digital resource needs and preferences across user characteristics among perinatal people in the United States. Future work should examine whether there are variations in interests within topics by user characteristics, which may provide additional opportunities to better meet user needs.
    Language English
    Publishing date 2024-01-12
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/48960
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Improving the Management of Maternal Mental Health with Digital Health Care.

    Guille, Constance / Henrich, Natalie / Brinson, Alison K / Jahnke, Hannah R

    Psychiatric research and clinical practice

    2023  Volume 6, Issue 1, Page(s) 23–32

    Abstract: Objectives: Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among ...

    Abstract Objectives: Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among peripartum people with a history of mental health disorders and determine which components of utilization associate with maternal mental health outcomes.
    Methods: Participants in this retrospective cohort analysis (
    Results: Multi-utilization exposure mixture models demonstrated that increasing use of digital resources by one quartile is associated with an increased odds of reporting that Maven helped users manage their mental health (aOR: 12.58 [95% CI: 6.74, 23.48]) and was not associated with self-reported incidence of PPD (aOR: 1.30 [95% CI: 0.52, 3.27]). Care advocate appointments, provider messages, and article reads were positively associated with improved mental health management.
    Conclusions: Digital health platforms, such as Maven, may play an important role in managing maternal mental health conditions among pregnant and postpartum people at high risk for PPD.
    Language English
    Publishing date 2023-11-29
    Publishing country United States
    Document type Journal Article
    ISSN 2575-5609
    ISSN (online) 2575-5609
    DOI 10.1176/appi.prcp.20230035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Association Between Doula Use on a Digital Health Platform and Birth Outcomes.

    Karwa, Smriti / Jahnke, Hannah / Brinson, Alison / Shah, Neel / Guille, Constance / Henrich, Natalie

    Obstetrics and gynecology

    2023  Volume 143, Issue 2, Page(s) 175–183

    Abstract: Objective: To examine the association between the use of virtual doula appointments on a comprehensive digital health platform and users' mode of birth and their birth experiences, among all platform users and Black platform users.: Methods: Data for ...

    Abstract Objective: To examine the association between the use of virtual doula appointments on a comprehensive digital health platform and users' mode of birth and their birth experiences, among all platform users and Black platform users.
    Methods: Data for this retrospective cohort study were extracted from individuals who enrolled in a comprehensive digital health platform, between January 1, 2020, and April 22, 2023. Multivariable logistic regression models were used to estimate the association between number of virtual doula appointments completed on the digital health platform and odds of cesarean birth and user-reported birth experience outcomes, which included help deciding a birth preference, receiving a high level of support during pregnancy, learning medically accurate information about pregnancy complications and warning signs, and managing mental health during pregnancy, stratified by parity. The interaction of doula utilization by race for each outcome was also tested.
    Results: Overall 8,989 platform users were included. The completion of at least two appointments with a virtual doula on the digital health platform was associated with a reduction in odds of cesarean birth among all users (adjusted odds ratio [aOR] 0.80, 95% CI, 0.65-0.99) and among Black users (aOR 0.32, 95% CI, 0.14-0.72). Among platform users with a history of cesarean birth, completion of any number of doula visits was associated with a reduction in odds of repeat cesarean birth (one visit: aOR 0.35, 95% CI, 0.17-0.72; two or more visits: aOR 0.37, 95% CI, 0.17-0.83). Analyses among all users indicated dose-response associations between increased virtual doula use and greater odds of users reporting support in deciding a birth preference (one visit: aOR 2.35, 95% CI, 2.02-2.74; two or more visits: aOR 3.67, 95% CI, 3.03-4.44), receiving a high level of emotional support during pregnancy (one visit: aOR 1.99, 95% CI, 1.74-2.28; two or more visits: aOR 3.26, 95% CI, 2.70-3.94), learning medically accurate information about pregnancy complications and warning signs (one visit: aOR 1.26, 95% CI, 1.10-1.44; two or more visits: aOR 1.55, 95% CI, 1.29-1.88), and help managing mental health during pregnancy (one visit: aOR 1.28, 95% CI, 1.05-1.56; two or more visits: aOR 1.78, 95% CI, 1.40-2.26).
    Conclusion: This analysis demonstrates that virtual doula support on a digital health platform is associated with lower odds of cesarean birth and an improved birth experience. Positive findings among Black users and users with vaginal birth after cesarean suggest that doula support is critical for patient advocacy, and that digital health may play a meaningful role in increasing health equity in birth outcomes.
    MeSH term(s) Female ; Humans ; Pregnancy ; Cesarean Section ; Digital Health ; Doulas ; Pregnancy Complications ; Retrospective Studies ; Pregnancy Outcome
    Language English
    Publishing date 2023-12-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000005465
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Impact of Physical Activity and Sedentary Behavior on Spontaneous Female and Male Fertility: A Systematic Review.

    Brinson, Alison K / da Silva, Shana G / Hesketh, Kathryn R / Evenson, Kelly R

    Journal of physical activity & health

    2023  Volume 20, Issue 7, Page(s) 600–615

    Abstract: Background: Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review ...

    Abstract Background: Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review the association between physical activity and sedentary behavior with spontaneous female and male fertility.
    Method: PubMed/MEDLINE, Web of Science, CINAHL, SPORTDiscus, and Embase were searched from inception to August 9, 2021. Eligible studies included randomized controlled trials or observational studies, published in English, describing an association between physical activity or sedentary behavior (exposures) and spontaneous fertility (outcome) among women or men.
    Results: Thirty-four studies from 31 unique populations were included in this review (12 cross-sectional studies, 10 cohort studies, 6 case-control studies, 5 randomized controlled trials, and one case-cohort study). Of the 25 studies among women, the majority identified mixed results (n = 11) or no association (n = 9) between physical activity and female fertility. Seven studies reported on female fertility and sedentary behavior, and 2 found sedentary behavior was associated with decreased female fertility. Of the 11 studies among men, most of the studies (n = 6) found that physical activity was associated with increased male fertility. Two of the studies reported on male fertility and sedentary behavior, and neither identified an association.
    Conclusions: The association between spontaneous fertility and physical activity in both men and women remains unclear, and the association with sedentary behavior remains largely unexplored.
    MeSH term(s) Pregnancy ; Humans ; Male ; Female ; Exercise ; Sedentary Behavior ; Cohort Studies ; Cross-Sectional Studies ; Fertility ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2023-05-05
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 1543-5474
    ISSN (online) 1543-5474
    DOI 10.1123/jpah.2022-0487
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Public health guidelines for physical activity during pregnancy from around the world: a scoping review.

    Hayman, Melanie / Brown, Wendy J / Brinson, Alison / Budzynski-Seymour, Emily / Bruce, Tracy / Evenson, Kelly R

    British journal of sports medicine

    2023  Volume 57, Issue 14, Page(s) 940–947

    Abstract: Background and objective: Despite the known health benefits of physical activity (PA), pregnancy is a time of marked decline in PA levels. To provide women with reliable and trustworthy information, and to encourage greater participation in PA during ... ...

    Abstract Background and objective: Despite the known health benefits of physical activity (PA), pregnancy is a time of marked decline in PA levels. To provide women with reliable and trustworthy information, and to encourage greater participation in PA during pregnancy, many governments have developed guidelines for PA during pregnancy. Our aim was to synthesise the most recent public health guidelines on PA during pregnancy from different countries in order to understand the nature and extent of advice that is available.
    Design: Scoping review.
    Data sources: Search of the grey literature, direct contact with international experts, screening of relevant academic literature and citation searching.
    Eligibility criteria: Public health guidelines developed or endorsed by government departments published since 2010.
    Results: Our search located 30 eligible guidelines, published in 11 different languages. There is remarkable concordance in the advice offered. For women with uncomplicated pregnancy, guidelines recommend: 150-300 min/week of moderate intensity aerobic activity; pelvic floor and muscle strengthening exercises; modification of some exercises (eg, supine position); and provide lists of warning signs to cease activity (eg, persistent dizziness, vaginal bleeding) and activities that should be avoided (eg, if high risk of falling/collision). Few guidelines offer specific advice for highly active women (eg, athletes), or trimester-specific or culturally specific considerations.
    Conclusions: This review provides a summary of public health recommendations for PA during pregnancy around the world. The challenge is now to ensure that all who provide healthcare for women understand the guidelines and encourage safe participation in PA during pregnancy.
    MeSH term(s) Pregnancy ; Female ; Humans ; Public Health ; Exercise ; Exercise Therapy
    Language English
    Publishing date 2023-01-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 600592-5
    ISSN 1473-0480 ; 0306-3674
    ISSN (online) 1473-0480
    ISSN 0306-3674
    DOI 10.1136/bjsports-2022-105777
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world.

    Evenson, Kelly R / Brown, Wendy J / Brinson, Alison K / Budzynski-Seymour, Emily / Hayman, Melanie

    Journal of sport and health science

    2023  

    Abstract: Background: The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to ... ...

    Abstract Background: The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide.
    Methods: To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country.
    Results: We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA.
    Conclusion: Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
    Language English
    Publishing date 2023-12-28
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2673028-5
    ISSN 2213-2961 ; 2095-2546
    ISSN (online) 2213-2961
    ISSN 2095-2546
    DOI 10.1016/j.jshs.2023.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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