Personalised mHealth strategies for gestational diabetes prevention

New study, published in Women’s Health, explores the engagement patterns of women at risk of gestational diabetes within the Bump2Baby and Me mHealth Coaching Programme. The study was led by Signe Bendsen, Research Scientist at Liva Healthcare.

Gestational diabetes poses a significant health challenge and behaviour change interventions, particularly those around diet and physical activity, are important for risk reduction. This retrospective study serves as a secondary analysis of a randomised controlled trial, focusing on engagement patterns among participants in the intervention arm who received digital health coaching.

The Liva app and coaching approach

The Bump2Baby and Me mHealth Coaching Programme, a mobile health intervention run as part of a clinical trial, was delivered by trained health coaches with expertise in nutrition, diet and maternal health. Coaching uses behavioural change theory and motivational interviewing, encouraging personalised support. The Liva app offers 13 variables for user interaction, including time spent in the app, message frequency, goal setting and intervention engagement. It explores the differences of participant engagement, an important factor in achieving positive health outcomes and seeks to understand how women engage with the app and its features.

Identifying engagement patterns

Analysing app usage data from 328 pregnant women within the intervention group during the first phase of the study identified three distinct engagement clusters:

• Averagers: moderate engagement with both coach and goal features
• Goalers: predominantly focused on goal features
• Immersers: high engagement with both coach and goal features.

Key findings from the research

This research reveals that engagement was inconsistent, even within a standardised programme. Notably, 82% of participants fell into the averagers category, suggesting a preference for a balanced and guided approach. The human element, represented by the health coach, plays a crucial role. Understanding these diverse engagement patterns is vital for tailoring mHealth interventions for personalised medicine, digital health and intervention development. As outlined in the paper, to enhance engagement in future interventions or research, we propose:

• Personalised engagement profiles: during onboarding, participants can discuss their preferred engagement style with their coach, leading to tailored programme delivery
• Streamlined goal tracking: reducing the frequency of required entries to minimise app input especially during pregnancy
• Re-evaluate learning and group features: potentially restructure or remove underutilised app features or implement structured online group meetings to increase engagement
• Focus on coach interaction: for averagers, emphasise the relationship with the coach, rather than focusing on app goal features.

Building on the findings

This research contributes to the understanding of how pregnant women engage with mHealth interventions. Further research is needed to validate the findings across more diverse populations and healthcare contexts to gain insights into the evolving engagement patterns during pregnancy and postpartum. Finally, future research could test and validate the suggested implications and changes in the app, to enhance engagement, based on the findings from this paper.

Paper

Signe B. Bendsen et al. Exploring engagement patterns within a mobile health intervention for women at risk of gestational diabetes. Women’s Health (2025).