User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study

Abstract Background Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India....

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Main Authors: Valentina Cox, Preetika Sharma, Garima Singh Verma, Navneet Gill, Nadia G. Diamond-Smith, Mona Duggal, Vijay Kumar, Rashmi Bagga, Jasmeet Kaur, Pushpendra Singh, Alison M. El Ayadi
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-02935-7
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author Valentina Cox
Preetika Sharma
Garima Singh Verma
Navneet Gill
Nadia G. Diamond-Smith
Mona Duggal
Vijay Kumar
Rashmi Bagga
Jasmeet Kaur
Pushpendra Singh
Alison M. El Ayadi
author_facet Valentina Cox
Preetika Sharma
Garima Singh Verma
Navneet Gill
Nadia G. Diamond-Smith
Mona Duggal
Vijay Kumar
Rashmi Bagga
Jasmeet Kaur
Pushpendra Singh
Alison M. El Ayadi
author_sort Valentina Cox
collection DOAJ
description Abstract Background Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators’ guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users’ perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth. Trial Registration ClinicalTrials.gov NCT04693585 (Registration date: 05/01/21).
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spelling doaj-art-579890cec7834cdc95e145dd6bb1fb862025-08-20T03:42:57ZengBMCBMC Medical Informatics and Decision Making1472-69472025-02-0125111510.1186/s12911-025-02935-7User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative studyValentina Cox0Preetika Sharma1Garima Singh Verma2Navneet Gill3Nadia G. Diamond-Smith4Mona Duggal5Vijay Kumar6Rashmi Bagga7Jasmeet Kaur8Pushpendra Singh9Alison M. El Ayadi10Institute for Global Health Sciences, University of California, San FranciscoPostgraduate Institute of Medical Education & ResearchPostgraduate Institute of Medical Education & ResearchPostgraduate Institute of Medical Education & ResearchInstitute for Global Health Sciences, University of California, San FranciscoPostgraduate Institute of Medical Education & ResearchSurvival of Women and Children FoundationPostgraduate Institute of Medical Education & ResearchDepartment of Computer Science & Engineering, Indraprastha Institute of Information TechnologyDepartment of Computer Science & Engineering, Indraprastha Institute of Information TechnologyDepartment of Epidemiology and Biostatistics, University of California, San FranciscoAbstract Background Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators’ guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users’ perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth. Trial Registration ClinicalTrials.gov NCT04693585 (Registration date: 05/01/21).https://doi.org/10.1186/s12911-025-02935-7IndiaAntenatalGroup caremHealthMobile phonePostnatal
spellingShingle Valentina Cox
Preetika Sharma
Garima Singh Verma
Navneet Gill
Nadia G. Diamond-Smith
Mona Duggal
Vijay Kumar
Rashmi Bagga
Jasmeet Kaur
Pushpendra Singh
Alison M. El Ayadi
User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
BMC Medical Informatics and Decision Making
India
Antenatal
Group care
mHealth
Mobile phone
Postnatal
title User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
title_full User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
title_fullStr User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
title_full_unstemmed User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
title_short User acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern India: a qualitative study
title_sort user acceptability and perceived impact of a mobile interactive education and support group intervention to improve postnatal health care in northern india a qualitative study
topic India
Antenatal
Group care
mHealth
Mobile phone
Postnatal
url https://doi.org/10.1186/s12911-025-02935-7
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