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      Pregnancy-Related Information Seeking and Sharing in the Social Media Era Among Expectant Mothers: Qualitative Study

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          Abstract

          Background

          Social media has become the most popular communication tool used by Chinese citizens, including expectant mothers. An increasing number of women have adopted various forms of social media channels, such as interactive websites, instant messaging, and mobile apps, to solve problems and obtain answers to queries during pregnancy. Although the use of the internet by pregnant women has been studied extensively worldwide, limited research exists that explores the changing social media usage habits in China, where the 1 child policy ended in 2015.

          Objective

          This study aimed to (1) present the status quo of pregnancy-related information seeking and sharing via social media among Chinese expectant mothers, (2) reveal the impact of social media usage, and (3) shed light on pregnancy-related health services delivered via social media channels.

          Methods

          A qualitative approach was employed to examine social media usage and its consequences on pregnant women. A total of 20 women who had conceived and were at various stages of pregnancy were interviewed from July 20 to August 10, 2017. Thematic analysis was conducted on the collected data to identify patterns in usage.

          Results

          Overall, 80% (16/20) of participants were aged in their 20s (mean 28.5 years [SD 4.3]). All had used social media for pregnancy-related purposes. For the seeking behavior, 18 codes were merged into 4 themes, namely, gravida, fetus, delivery, and the postpartum period; whereas for sharing behaviors, 10 codes were merged into 4 themes, namely, gravida, fetus, delivery, and caretaker. Lurking, small group sharing, bad news avoidance, and cross-checking were identified as the preferred patterns for using social media. Overall, 95% (19/20) of participants reported a positive mental impact from using social media during their pregnancy.

          Conclusions

          It is indisputable that social media has played an increasingly important role in supporting expectant mothers in China. The specific seeking and sharing patterns identified in this study indicate that the general quality of pregnancy-related information on social media, as well as Chinese culture toward pregnancy, is improving. The new themes that merge in pregnancy-related social media use represent a shift toward safe pregnancy and the promotion of a more enjoyable pregnancy. Future prenatal care should provide further information on services related to being comfortable during pregnancy and reducing the inequality of social media–based services caused by the digital divide.

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          Most cited references27

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          Effectiveness of mHealth interventions for maternal, newborn and child health in low– and middle–income countries: Systematic review and meta–analysis

          Objective To assess the effectiveness of mHealth interventions for maternal, newborn and child health (MNCH) in low– and middle–income countries (LMIC). Methods 16 online international databases were searched to identify studies evaluating the impact of mHealth interventions on MNCH outcomes in LMIC, between January 1990 and May 2014. Comparable studies were included in a random–effects meta–analysis. Findings Of 8593 unique references screened after de–duplication, 15 research articles and two conference abstracts met inclusion criteria, including 12 intervention and three observational studies. Only two studies were graded at low risk of bias. Only one study demonstrated an improvement in morbidity or mortality, specifically decreased risk of perinatal death in children of mothers who received SMS support during pregnancy, compared with routine prenatal care. Meta–analysis of three studies on infant feeding showed that prenatal interventions using SMS/cell phone (vs routine care) improved rates of breastfeeding (BF) within one hour after birth (odds ratio (OR) 2.01, 95% confidence interval (CI) 1.27–2.75, I2 = 80.9%) and exclusive BF for three/four months (OR 1.88, 95% CI 1.26–2.50, I2 = 52.8%) and for six months (OR 2.57, 95% CI 1.46–3.68, I2 = 0.0%). Included studies encompassed interventions designed for health information delivery (n = 6); reminders (n = 3); communication (n = 2); data collection (n = 2); test result turnaround (n = 2); peer group support (n = 2) and psychological intervention (n = 1). Conclusions Most studies of mHealth for MNCH in LMIC are of poor methodological quality and few have evaluated impacts on patient outcomes. Improvements in intermediate outcomes have nevertheless been reported in many studies and there is modest evidence that interventions delivered via SMS messaging can improve infant feeding. Ambiguous descriptions of interventions and their mechanisms of impact present difficulties for interpretation and replication. Rigorous studies with potential to offer clearer evidence are underway.
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            eHealth as the Next-Generation Perinatal Care: An Overview of the Literature

            Background Unrestricted by time and place, electronic health (eHealth) provides solutions for patient empowerment and value-based health care. Women in the reproductive age are particularly frequent users of internet, social media, and smartphone apps. Therefore, the pregnant patient seems to be a prime candidate for eHealth-supported health care with telemedicine for fetal and maternal conditions. Objective This study aims to review the current literature on eHealth developments in pregnancy to assess this new generation of perinatal care. Methods We conducted a systematic literature search of studies on eHealth technology in perinatal care in PubMed and EMBASE in June 2017. Studies reporting the use of eHealth during prenatal, perinatal, and postnatal care were included. Given the heterogeneity in study methods, used technologies, and outcome measurements, results were analyzed and presented in a narrative overview of the literature. Results The literature search provided 71 studies of interest. These studies were categorized in 6 domains: information and eHealth use, lifestyle (gestational weight gain, exercise, and smoking cessation), gestational diabetes, mental health, low- and middle-income countries, and telemonitoring and teleconsulting. Most studies in gestational diabetes and mental health show that eHealth applications are good alternatives to standard practice. Examples are interactive blood glucose management with remote care using smartphones, telephone screening for postnatal depression, and Web-based cognitive behavioral therapy. Apps and exercise programs show a direction toward less gestational weight gain, increase in step count, and increase in smoking abstinence. Multiple studies describe novel systems to enable home fetal monitoring with cardiotocography and uterine activity. However, only few studies assess outcomes in terms of fetal monitoring safety and efficacy in high-risk pregnancy. Patients and clinicians report good overall satisfaction with new strategies that enable the shift from hospital-centered to patient-centered care. Conclusions This review showed that eHealth interventions have a very broad, multilevel field of application focused on perinatal care in all its aspects. Most of the reviewed 71 articles were published after 2013, suggesting this novel type of care is an important topic of clinical and scientific relevance. Despite the promising preliminary results as presented, we accentuate the need for evidence for health outcomes, patient satisfaction, and the impact on costs of the possibilities of eHealth interventions in perinatal care. In general, the combination of increased patient empowerment and home pregnancy care could lead to more satisfaction and efficiency. Despite the challenges of privacy, liability, and costs, eHealth is very likely to disperse globally in the next decade, and it has the potential to deliver a revolution in perinatal care.
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              The use and value of digital media for information about pregnancy and early motherhood: a focus group study

              Background Many women in countries in the global North access digital media information sources during pregnancy and the early years of motherhood. These include websites, blogs, online discussion forums, apps and social media platforms. Little previous research has sought to investigate in detail how women use the diverse range of digital media now available to them and what types of information they value. A qualitative study using focus groups was conducted to address these issues. Methods Four focus groups were held in Sydney, Australia, including a total of 36 women who were either pregnant or had given birth in the previous three years. The participants were asked to talk about the types of digital media they used for pregnancy and parenting purposes, why they used them and in what ways they found them useful or helpful (or not). Group discussions were transcribed and thematically analysed, identifying the dominant information characteristics identified by women as valuable and useful. Results Nine characteristics emerged from the focus group discussions as most important to women: information that was: 1) immediate; 2) regular; 3) detailed; 4) entertaining; 5) customised; 6) practical; 7) professional; 8) reassuring; and 9) unbiased. These characteristics were valued for different purposes and needs. Digital media provided women with details when they most needed them or at times when they had opportunities to access them. The study showed that women value apps or digital platforms that are multi-functional. The findings revealed the importance of using digital information for establishing and maintaining social connections and intimate relationships with other mothers. However, participants also highly valued expert advice and expressed the desire for greater and more ready access to information and support offered by healthcare professionals. Conclusions Pregnant women and those with young children place a high value on the information and support they receive from and sharing using online sources and apps. They are accustomed to ready and immediate access to information using digital technologies and want better access to that offered by professionals. Recognising and finding ways to meet these needs should be included in planning healthcare provision and support for this group. Further research with women from socioeconomically disadvantaged backgrounds and non-urban locations is required to identify whether they have different information needs and values from the women who were included in the study reported here.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                December 2019
                4 December 2019
                : 21
                : 12
                : e13694
                Affiliations
                [1 ] College of Public Administration Huazhong University of Science and Technology Wuhan China
                [2 ] Center for Communication and Social Development School of Journalism and Communication Chongqing University Chongqing China
                [3 ] Smart Health Institute School of Medicine and Health Management, Tongji Medical College Huazhong University of Science and Technology Wuhan China
                [4 ] College of Engineering Design and Physical Sciences Brunel University London London United Kingdom
                [5 ] School of Public Administration Sichuan University Chengdu China
                Author notes
                Corresponding Author: Wei Zhang weizhanghust@ 123456hust.edu.cn
                Author information
                https://orcid.org/0000-0002-3879-9124
                https://orcid.org/0000-0002-8353-9479
                https://orcid.org/0000-0003-0178-0750
                https://orcid.org/0000-0001-6367-0560
                https://orcid.org/0000-0002-0664-7708
                Article
                v21i12e13694
                10.2196/13694
                6920903
                31799939
                4b3d4547-b5e9-44b7-a37d-522cb1ace4cd
                ©Chengyan Zhu, Runxi Zeng, Wei Zhang, Richard Evans, Rongrong He. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.12.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 13 February 2019
                : 30 August 2019
                : 26 September 2019
                : 22 October 2019
                Categories
                Original Paper
                Original Paper

                Medicine
                pregnant women,social media,information seeking,consumer health information,china
                Medicine
                pregnant women, social media, information seeking, consumer health information, china

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