A digital tool to support pregnancy planning, preparation and prevention

支持怀孕计划、准备和预防的数字工具

• 批准号: MR/Y503320/1
• 负责人: Jennifer Hall
• 金额: $ 29.74万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY503320%2F1
• 关键词: digital; tool; support; pregnancy; planning

"You're either on contraception or you're pregnant, and that middle step is missing". So said one woman in our qualitative research, describing the gap that we are attempting to fill. We are developing a digital tool to support people of reproductive age to understand their pregnancy preferences and to develop and implement a reproductive life plan; helping prevent unplanned pregnancies, improve pregnancy planning, preparations and outcomes, and reduce inequalities in maternal health.Nearly half of all pregnancies in the UK are unplanned, and discussions around pregnancy planning are not routine in healthcare settings; this results in missed opportunities to optimise health before pregnancy. Currently, over nine out of ten women conceive with at least one modifiable risk factor; this is widely recognised to be a major contributor to maternal mortality and morbidity, and particularly to the inequalities in outcomes for black and minority ethnic groups. Meanwhile, it has also become increasingly difficult to access contraception in the UK over the last few years which, when coupled with dissatisfaction and discontinuation of contraception, contributes to unplanned pregnancies, which are associated with increased risks of stillbirth, preterm birth, low birthweight, neonatal mortality and postnatal depression.There is an unmet and expressed need among people of reproductive age for support to develop and meet their reproductive goals. Furthermore there is a gap in the market for a tool that can support people of reproductive age identify their fertility intentions and develop a reproductive life plan. Our app uniquely combines both pregnancy prevention and preparation needs, in one place. Our extensive qualitative and quantitative research (>100 hours of interviews and survey data from >3000 people) has informed our decision to create a digital tool, while the content, look and feel of the app has been rigorously co-developed, meaning the whole tool is evidence-based and user centred.We have already co-developed a minimum viable product of the app which guides users through a series of questions about their reproductive preferences. Our algorithm, based on the validated Desire to Avoid Pregnancy Scale and derived through extensive data analysis, accurately predicts the probability of pregnancy. We have digitised this algorithm, incorporated it into the app, and mapped it to the Fertility Intention Typology (FIT), creating a simple-to-use tool for users who are presented with their FIT, likelihood of pregnancy, and tailored advice (see Supporting data 1).We plan to further develop this app by building in an interactive reproductive life plan, taking the user from simply identifying their preferences to taking actions to achieve them. The app will guide users through a dynamic pathway of questions and prompts; supporting the individual to reflect on their own reproductive goals. Their answers will shape the questions presented, encouraging deeper engagement. Avatars will be used to improve usability and engagement, along with in-built optional to-do items and reminders to help users achieve their goals.We will use the COM-B model of behaviour change to guide the development; this person-centred approach can increase autonomy and self-efficacy and will enable healthcare professionals to better support individuals to meet their aims. Once developed, we will pilot the app in relevant settings (including education and healthcare settings) to gain preliminary data. At project end we will have a fully co-developed app which will be ready for implementation.

“你要么正在采取避孕措施，要么已经怀孕了，而中间的步骤却缺失了”。我们的定性研究中的一位女性如此说道，她描述了我们试图填补的空白。我们正在开发一种数字工具，以支持育龄人士了解他们的怀孕偏好并制定和实施生殖生活计划；帮助预防意外怀孕，改善怀孕计划、准备和结果，并减少孕产妇健康方面的不平等。英国近一半的怀孕是计划外的，围绕怀孕计划的讨论在医疗机构中并不常见；这会导致错过怀孕前优化健康的机会。目前，超过十分之九的女性在怀孕时至少存在一种可改变的风险因素；人们普遍认为，这是造成孕产妇死亡率和发病率，特别是黑人和少数族裔群体结果不平等的一个主要原因。与此同时，在过去几年里，在英国获得避孕药具也变得越来越困难，再加上避孕药具的不满和停止，导致了计划外怀孕，这与死产、早产、低出生体重的风险增加有关。新生儿死亡率和产后抑郁症。育龄人群在制定和实现其生殖目标方面存在着未得到满足和明确的支持支持需求。此外，市场上还存在一个能够支持育龄人群确定生育意图并制定生育生活计划的工具的缺口。我们的应用程序将怀孕预防和准备需求独特地结合在一处。我们广泛的定性和定量研究（超过 100 小时的访谈和超过 3000 人的调查数据）为我们决定创建数字工具提供了依据，而应用程序的内容、外观和感觉都是经过严格共同开发的，这意味着整个该工具以证据为基础，以用户为中心。我们已经共同开发了该应用程序的最低可行产品，指导用户回答一系列有关其生殖偏好的问题。我们的算法基于经过验证的“避免怀孕意愿量表”，并通过广泛的数据分析得出，可以准确预测怀孕的概率。我们已将该算法数字化，将其合并到应用程序中，并将其映射到生育意向类型 (FIT)，为向用户提供 FIT、怀孕可能性和定制建议的简单易用的工具（请参阅支持数据 1).我们计划通过构建交互式生殖生活计划来进一步开发该应用程序，使用户从简单地确定自己的偏好到采取行动来实现它们。该应用程序将引导用户通过问题和提示的动态路径；支持个人反思自己的生殖目标。他们的答案将影响所提出的问题，鼓励更深入的参与。头像将用于提高可用性和参与度，以及内置的可选待办事项和提醒，以帮助用户实现目标。我们将使用行为改变的 COM-B 模型来指导开发；这种以人为本的方法可以提高自主性和自我效能，并使医疗保健专业人员能够更好地支持个人实现其目标。一旦开发完成，我们将在相关环境（包括教育和医疗保健环境）中试用该应用程序，以获得初步数据。在项目结束时，我们将拥有一个完全共同开发的应用程序，可供实施。