Table 2_Mobile health (mHealth) interventions for health promotion during the perinatal period in India: a scoping review.docx

IntroductionPerinatal and maternal mortality rates remain high in India compared to global levels, and there is significant heterogeneity in outcomes across Indian states. Many mobile health (mHealth) interventions have been developed to improve maternal and infant health outcomes in India, however it is unclear how mHealth can best support women in this culturally and resource diverse setting. Therefore, we aimed to identify mHealth interventions targeting women and their families in the perinatal period in India, identify barriers and facilitators to their uptake, and future research directions.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Joanna Briggs Institute guidelines for scoping reviews was used for study selection and screening and the mHealth evidence reporting and assessment checklist was used for evaluating mHealth interventions. PubMed, CINAHL, Global Health, and ACM digital library were searched for records up to 2 April 2023. Studies were included where women who were pregnant, planning for a child, or in the 12 months after delivery, and their families, living in India received health advice via a technological medium.Results1,783 records were screened, 29 met the inclusion criteria, describing 22 different mHealth interventions. Most frequent behavioural targets for interventions were breastfeeding, antenatal nutrition, and infant healthcare. Most interventions communicated to women through one-way communication methods, most frequently SMS. Participants reported positive views of mHealth, reported facilitators included group communication, use of non-maternal informative content, and a pictorial information format. Reported barriers included household responsibilities, technical difficulties, difficulty accessing a phone and difficulty understanding, or misinterpreting messages.DiscussionWe conclude that mHealth interventions are acceptable to women in India during the perinatal period. However, current interventions lack evidence of long term behavioural change and fail to report on features important in sustainability and scalability, namely network infrastructure, data security and interoperability. We propose the need for a framework to understand existing cultural beliefs and support structures to avoid early intervention failure. Future research should investigate multimodal mHealth interventions for behavioural change, identify the appropriate frequency and format of mHealth messages, and address access limitations such as shared mobile phone ownership, and illiteracy rates.

相较于全球水平，印度的围产期和孕产妇死亡率仍然居高不下，且印度各邦之间的健康结果存在显著的异质性。众多移动健康（mHealth）干预措施已被开发，旨在改善印度的孕产妇及婴幼儿健康结果，然而，在文化及资源多元的背景下，尚不明确mHealth如何才能最好地支持该地区的女性。因此，本研究旨在识别针对印度围产期女性及其家庭的mHealth干预措施，探究其应用过程中的障碍与促进因素，并展望未来的研究方向。研究方法方面，本研究采用了《系统评价与Meta分析报告规范》以及乔安娜·布里格斯研究所关于范围性综述的指南，用于研究的选择和筛选，并利用mHealth证据报告与评估清单对mHealth干预措施进行评估。检索了PubMed、CINAHL、全球健康数据库和ACM数字图书馆，直至2023年4月2日的相关记录。纳入标准为：居住在印度的孕妇、计划怀孕的女性或在分娩后12个月内的女性及其家庭，通过技术手段接受健康咨询的研究。研究结果：共筛选出1,783条记录，其中29条符合纳入标准，描述了22种不同的mHealth干预措施。干预措施中最常见的目标行为是母乳喂养、孕前营养和婴幼儿健康管理。大多数干预措施通过单向沟通方式与女性进行交流，其中最常见的沟通方式是短信。参与者对mHealth持有积极看法，促进因素包括群体沟通、使用非孕产妇信息内容以及图文信息格式。障碍因素包括家务责任、技术困难、难以获取电话以及理解或误解信息。讨论：我们得出结论，mHealth干预措施在印度的围产期得到了女性的认可。然而，现有干预措施缺乏长期行为改变的证据，且未能报告对可持续性和可扩展性重要性的特征，如网络基础设施、数据安全与互操作性。我们提出，需要建立一个框架来理解现有的文化信仰和支持结构，以避免早期干预的失败。未来的研究应调查多模式mHealth干预措施对行为改变的影响，确定mHealth信息的适当频率和格式，并解决访问限制问题，如共享手机所有权和文盲率。