"What About Mom? Teen: Usability of a Postpartum App for Teen Mothers"

Purpose: Age serves as a strong indicator of a woman's risk for complication and death resulting from pregnancy. Most countries including the U.S., show a J-shaped pattern of maternal-mortality risk, with adolescents having a greater risk of maternal mortality than women in their twenties and early thirties (Restrepo-Mendez & Victora, 2014). Additionally, the United States is the only developed country in the world where postpartum death rates (within one year after giving birth) are rising. Within the last decade, the use of smart phones and computers to access medical information has increased. However, there remains a gap in research and availability of apps to deliver postpartum instruction to adolescent mothers. Given this lack in information, we hypothesized that the What About Mom? App can fill this gap for postpartum teens ages 16-19 years old. The purpose of this study was to examine the usability of an app displaying postpartum warning signs for new teen moms to identify a need for care for urgent/ emergent medical conditions. Methods: Participants were recruited via email lists and ads on social media of community partners serving new mothers in both English and Spanish. Participants completed a survey that assessed their perception of the What About Mom? Apps' quality and usability. This was measured using the User Version Mobility Assessment Rating Scale (uMARS). The survey also gathered demographic information from the participants and assessed e-health literacy. E-health literacy was determined using the eHeals assessment scale which is the most commonly used validated measure for e-health literacy Results: Data was cleaned and 159 credible responses were garnered. Compared with the standard scores in each of the uMARS domains: Engagement, Functionality, Aesthetics, Information, and Subjective Quality; the What About Mom? App had the lowest rating in Information (3.48) and highest rating in Aesthetics (3.68). Qualitative suggestions were made from the participants to improve Information. The mean total score for eHEALs was 30.0 (range 8-40; SD 5.9). The highest score was for the item "I know how to use the health information I find on the Internet to help me," and the lowest score was for "I have the skills I need to evaluate the health resources I find on the Internet". Conclusion: Knowing that postpartum moms report searching online for health information, understanding the association between e-health literacy, use of technology, health information-seeking behavior, and ability to apply health information is an important step in creating e-health messages, programs, and interventions to prevent maternal morbidity and mortality in disparate areas and age groups. Apps including The What About Mom? App are promising interventions that can help increase healthcare engagement for not only moms above 20 years of age but also adolescent moms to help reduce age, racial and ethnic disparities in teen maternal morbidity and mortality.