Research News

Study finds strong approval for mHealth supports for overweight and obese women during pregnancy

  • 28 May, 2021


A further analysis of the PEARS (Pregnancy, Exercise and Nutrition Study with Smartphone APP Support) study, was published in JMIR Mhealth on 17 May.


The PEARS trial was originally conducted between 2013 and 2016 at the NMH to evaluate the effect of a healthy lifestyle package on the incidence of GDM (Gestational Diabetes Mellitus) in 565 pregnant women (with a median age of 20 years) who were overweight or obese. The healthy lifestyle package comprised low GI dietary advice, a daily exercise prescription and a Smartphone APP, in addition to standard obstetric care. The further analysis focused on acceptability of the healthy lifestyle package specifically using the Smartphone APP support.  


During the PEARS trial, acceptability questionnaires were completed by the intervention group in the study at 28 weeks gestation and at the end of the study (post intervention). Maternal characteristics were also recorded including age, ethnicity, BMI and socio-economic status. In addition, 28 study participants also took part in one-to-one semi-structured interviews where they shared their experience of the PEARS intervention.


 The results from the further analysis of the PEARS data as published today showed that:

  • The healthy lifestyle package intervention was generally accepted
  • 68% of study participants stated that the diet was easy to follow
  • 77% stated that the diet was affordable
  • 80% stated that using the APP was enjoyable (this was especially associated with disadvantaged neighbourhood deprivation index and higher BMI)
  • 97% stated that the APP was easy to use


Speaking about these positive results, Fionnuala McAuliffe, Professor of Obstetrics and Gynaecology, NMH, Director, UCD Perinatal Research Centre and JMIR Mhealth paper author said: "The Smartphone APP designed for the PEARS study proved to be a convenient and economical tool for communication with our patients during pregnancy, especially for communication with those who have few resources to obtain health information. But importantly our further analysis of the data from this study shows that the mobile technology has to be designed accordingly and low-income populations and maternal demographics should be considered in the development of the diet and lifestyle intervention APPs to encourage uptake.

"In this regard the Smartphone APP provided to the intervention group was a study-specific APP designed by a multidisciplinary team which included a dietician, obstetrician, food behaviour specialist and APP design company and we conducted focus groups with women during the APP development to ensure their needs and wants were catered for. Following this expert input and extensive consultation process, the APP’s text was developed for a reading age of 12 years to allow those with low literacy levels to engage with the APP. It was also developed in an easy-to-use format to allow for digital literacy. This APP, called HOLLESTIC, which has now been developed by NMH is free to download on the APP store, is an excellent example of how clinical research can result in improvements to clinical care."


Also speaking about the results from this further analysis of the PEARS study, Professor Peter Doran, Associate Dean for Research, Innovation and Impact, UDC School of Medicine, said: "We are totally supportive of the development of mHealth technology as a component of research interventions in both pregnant and non-pregnant cohorts. However, the majority of published studies used mHealth in the form of text messaging, websites, and fitness trackers and there is a lack of data on the acceptability of the use of mHealth in the form of a smartphone APP, specifically to support a mixed lifestyle intervention in pregnancy. So the acceptability of the smartphone APP in the PEARS diet and lifestyle intervention, with greater acceptability associated with low education and low income level is very welcome to inform future similar mHealth development to drive better health outcomes."


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