MyHealthyPregnancy mobile health app: Combining behavioral science and machine learning for risk communication during the peripartum period

MyHealthyPregnancy 移动健康应用程序：结合行为科学和机器学习进行围产期风险沟通

• 批准号: 10396887
• 负责人: Anabel F Castillo
• 金额: $ 49.8万
• 依托单位: NAIMA HEALTH, LLC
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10396887
• 关键词: MyHealthyPregnancy; mobile; health; app; Combining

Project Summary/Abstract Problem: Depression during pregnancy affects approximately 10% of women and is related to low birthweight and preterm birth. Similarly, up to 9% of pregnant women experience intimate partner violence (IPV) and abuse, with over 41% of assaults resulting in physical injury, and almost 30% requiring medical treatment. When untreated, these risks cost health systems at least $50B/year. Mitigation has proven difficult, where women are reluctant to disclose during clinical visits, and clinicians are unaware of resources. There are no integrated health technologies that enable timely disclosure of risks during pregnancy then aid in making decisions about risk mitigation. Fortunately, most women of reproductive age own a smartphone, and users report comfort disclosing health information to smartphones under the right conditions. Naima Health’s Proposed Solution: Naima Health is developing a digital health platform that pairs our MyHealthyPregnancy (MHP) smartphone application with an EPIC-integrated provider portal to (i) identify risks early in pregnancy, (ii) communicate those risks to women and their providers, and (iii) assist decision-making about risk mitigation. MHP identifies risk using ACOG-approved screenings, then helps patients and providers make real-time decisions about mitigation. The proposed solution aligns with the CDC’s priority of developing mobile app-based decision support systems for mental health and IPV screening, assessment, and referral. Proposed SBIR Work: In Phase I we developed expert and machine learning models to identify risks during pregnancy, then characterized issues facing Spanish-speaking women. In Phase II we extend these Phase I results using semi-structured interviews with patients and providers to understand site-specific requirements for psychosocial risk screening and referral, then update the MHP platform to meet those requirements (Aim 1). We then validate the updated platform’s performance using qualitative cognitive testing with patients and providers to ensure the platform meets site-specific requirements (Aim 2). Finally, we evaluate the platform’s acceptability and feasibility at two collaborating clinic sites, focusing on the rate of depression and IPV detected through the platform compared to historical rates, and the prevalence of risk mitigation actions measured through patient calls/click-throughs and provider referrals (Aim 3).

项目摘要/摘要 问题：怀孕期间的抑郁会影响约10％的女性，并且与低 出生体重和早产。同样，多达9％的孕妇经历亲密伴侣暴力 （IPV）和虐待，超过41％的袭击导致身体伤害，几乎需要医疗的30％ 治疗。如果不进行治疗，这些风险将使卫生系统至少为50B美元/年。缓解已证明 困难，妇女在临床访问期间不愿披露，而临床医生不知道 资源。没有集成的健康技术可以及时披露风险 怀孕然后有助于做出有关降低风险的决定。幸运的是，大多数生殖女性 年龄拥有智能手机，用户将舒适性报告给智能手机披露健康信息 正确的条件。 Naima Health提出的解决方案：Naima Health正在开发一个数字健康平台，该平台将我们的 MyHealthyPregnancy（MHP）智能手机应用程序，并具有（i）的Epic集成提供商门户 （ii）在怀孕初期确定风险，将这些风险传达给妇女及其提供者，以及（iii）协助 关于降低风险的决策。 MHP使用ACOG批准的筛选确定风险，然后帮助 患者和提供者就缓解做出实时决定。提出的解决方案与 疾病预防控制中心（CDC）优先开发基于移动应用的心理健康和IPV决策支持系统 筛选，评估和推荐。 拟议的SBIR工作：在第一阶段，我们开发了专家和机器学习模型以识别风险 在怀孕期间，然后是说西班牙语女性面临的问题。在第二阶段，我们扩展了这些 第一阶段的结果使用与患者和提供者的半结构式访谈，以了解特定地点 对社会心理风险筛查和推荐的要求，然后更新MHP平台以满足这些平台 要求（目标1）。然后，我们使用定性认知来验证更新的平台的性能 与患者和提供者进行测试，以确保平台满足特定地点的要求（AIM 2）。最后， 我们在两个合作诊所网站上评估了该平台的可接受性和可行性，重点介绍了费率 与历史速率相比，通过平台检测到的抑郁症和IPV的流行 通过患者呼叫/点击通话和提供者推荐来衡量的风险缓解行动（AIM 3）。