ABSTRACT
AIM: The objective is to use the available technology in conjunction with the peripheral health workers to identify the early warning signs of pregnancy-induced hypertension (PIH), provide appropriate referral services and closely monitor the patient thereafter with the aim of improving the prognosis of the condition. STUDY DESIGN: Quasi-experimental design. METHOD: The research will be carried out in Udupi District Karnataka, India. The study will involve 250 pregnant women in total as well as 50 ASHA workers. All the participants will undergo a PIH knowledge assessment, which will be followed by a PIH risk assessment for expectant mothers. There will be an implementation of the community-managed intervention programme (CMIP). The creation of a mobile application, ongoing prenatal follow-up and training for ASHAs on mobile app usage are all part of the CMIP. The results for mothers and newborns will be monitored and to learn more about the efficacy of CMIP and the difficulties ASHA workers and expectant mothers encounter in identifying the early warning signals of PIH a focused group discussion will be held. DISCUSSION: A number of research on pregnancy-induced hypertension have demonstrated the necessity for community-based treatments to be developed in order to improve the outcomes for expectant mothers and newborns. These programmes assist in managing hypertension throughout pregnancy. Conversely, ASHA employees have had a favourable influence on community-level health outcome management. Currently, technology is being used extensively in healthcare and is receiving favourable reception. Thus, in an effort to improve maternal and newborn outcomes, this study attempts to incorporate mobile technologies in addition to ASHA workers and pregnant women. IMPACT: If the CMIP proves to be beneficial, it might be implemented nationwide, particularly in isolated regions, to monitor expectant mothers and avoid PIH-related concerns.
ABSTRACT
BACKGROUND: Hypertension is one of the most prevalent medical conditions that arise during pregnancy, resulting in maternal and neonatal complications. Mobile health (mHealth) has emerged as an innovative intervention for delivering maternal and child health care services. The evidence on the effectiveness of mHealth interventions in improving the health outcomes of pregnant women with hypertensive disorders is lacking. Therefore, there is a need for evidence synthesis using systematic review methods to address this evidence gap. OBJECTIVE: This review aims to determine the efficacy of mHealth interventions in improving maternal and neonatal outcomes among pregnant women with hypertensive disorders. The review will answer the following research questions: (1) What are the types of mHealth interventions used in pregnant women with hypertensive disorders? (2) Are the various mHealth interventions effective in improving maternal and neonatal health outcomes, health behaviors, and their knowledge of the disease? and (3) Are mHealth interventions effective in supporting health care providers to make health care decisions for pregnant women with hypertensive disorders? METHODS: This review will include randomized controlled trials, nonrandomized controlled trials, and cohort studies focusing on mHealth interventions for pregnant women with hypertensive disorders. Studies reporting health care providers use of mHealth interventions in caring for pregnant women with hypertensive disorders will be included. The search strategy will be tailored to each database using database-specific search terms. The search will be conducted in PubMed-MEDLINE, ProQuest, CINAHL, Scopus, Web of Science, and CENTRAL. Other literature sources, such as trial registries and bibliographies of relevant studies, will be additionally searched. Studies published in English from January 2000 to January 2023 will be included. A total of 2 review authors will independently perform the data extraction and the quality appraisal. For quality appraisal of randomized controlled trials, the Cochrane Risk of Bias 2 tool will be used. The Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-1) tool will be used for nonrandomized controlled trials, and the Critical Appraisal Skills Programme checklist for cohort studies will be used. Any disagreements between the 2 reviewers will be resolved through discussion and a third reviewer if required. A meta-analysis will be performed based on the availability of the data. RESULTS: As per the protocol, the study methodology was followed, and 2 independent reviewers conducted the search in 6 databases and clinical registries. Currently, the review is in the full-text screening stage. The review will publish the results in the first quarter of 2024. CONCLUSIONS: The evidence synthesized from this systematic review will help guide future research, support health care decisions, and inform policy makers on the effectiveness of mHealth interventions in improving the maternal and neonatal outcomes of pregnant women with hypertensive disorders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51792.
