Toward Safer Pregnancies: Usability evaluation of a prototype application for monitoring and controlling hypertensive disorders in pregnancy

Mel Imanol Nielsen Pimentel; Vladimir Villarreal; Lilia Esther Muñoz Arracera; Joseph Antony González Gómez; Danilo Domínguez Perez

doi:10.16925/2357-6014.2023.03.10

Toward Safer Pregnancies : Usability evaluation of a prototype application for monitoring and controlling hypertensive disorders in pregnancy

Research Articles

https://doi.org/10.16925/2357-6014.2023.03.10

Mel Imanol Nielsen Pimentel Ver Biografía

Universidad Tecnológica de Panamá

Vladimir Villarreal Contreras Ver Biografía

Universidad Tecnológica de Panamá

Lilia Esther Muñoz Arracera Ver Biografía

Universidad Tecnológica de Panamá

Joseph Antony González Gómez Ver Biografía

Universidad Tecnológica de Panamá

Danilo Domínguez Perez Ver Biografía

Universidad Tecnológica de Panamá

Introduction: Hypertensive disorders in pregnancy pose global health challenges. Maternal mortality rates in Panama due to preeclampsia and eclampsia have increased. A mobile application is introduced to monitor and control these disorders.

Problem: Hypertensive disorders in pregnancy pose a risk to maternal health. Panama’s healthcare initiatives have shown progress, but there are still gaps in maternal care. Novel technologies may help address these gaps.

Objective: The goal is to evaluate a prototype mobile app for managing hypertensive disorders in pregnancy. Research focuses on usability, including navigation, design-task correlation, acceptability, and user perspectives.

Methodology: The Design Science Research Methodology (DSRM) guides the study through problem identification, motivation, and software artifact development. The evaluation involves 32 participants engaging in tasks and standardized questionnaires, including the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Tasks assess the app’s usability, while questionnaires provide comprehensive insights into user experiences.

Results: Users generally have positive interactions and favorable perceptions. However, there are challenges with task completion, particularly with interface intuitiveness.

Conclusion: The app for monitoring hypertensive disorders has shown positive user experiences and usability. However, there are challenges and user feedback that need to be addressed for refinement and effectiveness in supporting maternal health during pregnancy.

Limitations: The study focuses only on the prototype evaluation phase and may need further iterations to address challenges. The participant pool’s limitations may impact generalizability. Ongoing improvements are crucial to meet evolving user needs and technological advancements.

Originality: This article contributes originality by presenting a novel mobile application prototype for managing hypertensive disorders in pregnancy. The use of DSRM for development and comprehensive usability assessments with standardized tools adds to the originality, providing valuable insights for future advancements in maternal healthcare technology.

Keywords: Hypertensive disorders in pregnancy, Mobile health application, Usability evaluation, Design Science Research Methodology (DSRM), System Usability Scale (SUS), User Experience Questionnaire (UEQ)

Organización Mundial de la Salud, “Recomendaciones de la OMS para la prevención y el tratamiento de la preeclampsia y la eclampsia,” Ginebra, 2014. [Online]. Available: https://apps.who.int/iris/handle/10665/138405

J. Wang, G. Zhang, W. Wang, K. Zhang, and Y. Sheng, “Cloud-Based Intelligent Self-Diagnosis and Department Recommendation Service Using Chinese Medical BERT,” vol. 10, no. 1, doi: 10.1186/s13677-020-00218-2.

P. T. Yeh et al., “Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review,” BMC Pregnancy Childbirth, vol. 22, no. 1, Dec. 2022, doi: 10.1186/s12884-022-04751-7.

L. Pealing et al., “Perceptions and experiences of blood pressure self-monitoring during hypertensive pregnancy: A qualitative analysis of women’s and clinicians’ experiences in the OPTIMUM-BP trial,” Pregnancy Hypertens, vol. 30, pp. 113–123, Dec. 2022, doi: 10.1016/j.preghy.2022.09.006.

Organización Panamericana de la Salud, Recomendaciones Para Establecer Un Sistema Nacional de Vigilancia de La Morbilidad Materna Extremadamente Grave En América Latina y El Caribe. Pan American Health Organization. doi: 10.37774/9789275323915.

I. González, J. Fontecha, R. Hervás, and J. Bravo, “An Ambulatory System for Gait Monitoring Based on Wireless Sensorized Insoles,” Sensors, vol. 15, no. 7, pp. 16589–16613, Jul. 2015, doi: 10.3390/s150716589.

M. W. L. Moreira, J. J. P. C. Rodrigues, A. K. Sangaiah, J. Al-Muhtadi, and V. Korotaev, “Semantic interoperability and pattern classification for a service-oriented architecture in pregnancy care,” Future Generation Computer Systems, vol. 89, pp. 137–147, Dec. 2018, doi: 10.1016/j.future.2018.04.031.

M. W. L. Moreira, J. J. P. C. Rodrigues, J. Al‐Muhtadi, V. V Korotaev, and V. H. C. Albuquerque, “Neuro‐fuzzy model for HELLP syndrome prediction in mobile cloud computing environments,” Concurrency Computat Pract Exper, vol. 33, no. 7, p. 1, Apr. 2021, doi: 10.1002/cpe.4651.

J. G. D. de Souza and D. Scherer, “Gestation: A Microservice Architecture for a Prenatal Care Application,” in Proceedings - 2021 IEEE 45th Annual Computers, Software, and Applications Conference, COMPSAC 2021, Institute of Electrical and Electronics Engineers Inc., pp. 683–687. doi: 10.1109/COMPSAC51774.2021.00099.

N. El aboudi and L. Benhlima, “Big Data Management for Healthcare Systems: Architecture, Requirements, and Implementation,” Adv Bioinformatics, vol. 2018, pp. 1–10, Jun. 2018, doi: 10.1155/2018/4059018.

Y. Santur, S. G. Santur, and M. Karaköse, “Architecture and implementation of a smart‐pregnancy monitoring system using web‐based application,” Expert Syst, vol. 37, no. 1, Feb. 2020, doi: 10.1111/exsy.12379.

F. Sarhaddi et al., “Long-Term IoT-Based Maternal Monitoring: System Design and Evaluation,” Sensors, vol. 21, no. 7, p. 2281, 2021.

S. Veena and D. J. Aravindhar, “Remote Monitoring System for the Detection of Prenatal Risk in a Pregnant Woman,” Wirel Pers Commun, vol. 119, no. 2, pp. 1051–1064, Jul. 2021, doi: 10.1007/s11277-021-08249-x.

A. C. de Kat et al., “Preeclampsia prediction with blood pressure measurements: A global external validation of the ALSPAC models,” Pregnancy Hypertens, vol. 30, pp. 124–129, Dec. 2022, doi: 10.1016/j.preghy.2022.09.005.

S. Roca, J. Sancho, J. García, and Á. Alesanco, “Microservice chatbot architecture for chronic patient support,” J Biomed Inform, vol. 102, p. 103305, Feb. 2020, doi: 10.1016/j.jbi.2019.103305.

D. Bender and K. Sartipi, “HL7 FHIR: An Agile and RESTful Approach to Healthcare Information Exchange,” in Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems, IEEE, pp. 326–331. doi: 10.1109/CBMS.2013.6627810.

R. Wallace, “The elements of AIML style,” Alice AI Foundation, vol. 139, 2003.

S. Kumar, Y. Gupta, and V. Mago, “Health-Monitoring of Pregnant Women: Design Requirements, and Proposed Reference Architecture,” in 2019 16th IEEE Annual Consumer Communications & Networking Conference (CCNC), IEEE, pp. 1–6.

D. Bjelica, A. Bjelica, M. Despotović-Zrakić, B. Radenković, D. Barać, and M. Đogatović, “Designing an IT Ecosystem for Pregnancy Care Management Based on Pervasive Technologies,” Healthcare, vol. 9, no. 1, p. 12, Dec. 2020, doi: 10.3390/healthcare9010012.

H. Wilson et al., “Self-monitoring of blood pressure in pregnancy: A mixed methods evaluation of a national roll-out in the context of a pandemic,” Pregnancy Hypertens, vol. 30, pp. 7–12, Dec. 2022, doi: 10.1016/j.preghy.2022.07.006.

J. F. M. van den Heuvel, S. S. Kariman, W. W. van Solinge, A. Franx, A. T. Lely, and M. N. Bekker, “SAFE@ HOME–Feasibility study of a telemonitoring platform combining blood pressure and preeclampsia symptoms in pregnancy care,” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 240, pp. 226–231, 2019.

K. Peffers, T. Tuunanen, M. A. Rothenberger, and S. Chatterjee, “A design science research methodology for information systems research,” Journal of Management Information Systems, vol. 24, no. 3, pp. 45–77, Dec. 2007, doi: 10.2753/MIS0742-1222240302.

K. Fan and Y. Zhao, “Mobile health technology: a novel tool in chronic disease management,” Intelligent Medicine, vol. 2, no. 1, pp. 41–47, Feb. 2022, doi: 10.1016/j.imed.2021.06.003.

I. Sim, “Mobile Devices and Health,” New England Journal of Medicine, vol. 381, no. 10, pp. 956–968, Sep. 2019, doi: 10.1056/NEJMra1806949.

Y. Ranjan et al., “Radar-base: Open source mobile health platform for collecting, monitoring, and analyzing data using sensors, wearables, and mobile devices,” JMIR Mhealth Uhealth, vol. 7, no. 8, 2019, doi: 10.2196/11734.

M. Espinilla, J. Medina, Á. L. García-Fernández, S. Campaña, and J. Londoño, “Fuzzy Intelligent System for Patients with Preeclampsia in Wearable Devices,” Mobile Information Systems, vol. 2017, 2017, doi: 10.1155/2017/7838464.

M. Saxena and A. Saxena, “Evolution of mHealth Eco-System: A Step Towards Personalized Medicine,” 2020, pp. 351–370. doi: 10.1007/978-981-15-1286-5_30.

Z. Wang et al., “From Personalized Medicine to Population Health: A Survey of mHealth Sensing Techniques,” IEEE Internet Things J, vol. 9, no. 17, pp. 15413–15434, Sep. 2022, doi: 10.1109/JIOT.2022.3161046.

D. Stefanicka-Wojtas and D. Kurpas, “eHealth and mHealth in Chronic Diseases—Identification of Barriers, Existing Solutions, and Promoters Based on a Survey of EU Stakeholders Involved in Regions4PerMed (H2020),” J Pers Med, vol. 12, no. 3, p. 467, Mar. 2022, doi: 10.3390/jpm12030467.

X. Xu, R. Mo, F. Dai, W. Lin, S. Wan, and W. Dou, “Dynamic Resource Provisioning With Fault Tolerance for Data-Intensive Meteorological Workflows in Cloud,” IEEE Trans Industr Inform, vol. 16, no. 9, pp. 6172–6181, Sep. 2020, doi: 10.1109/TII.2019.2959258.

R. K. Gupta, M. Venkatachalapathy, and F. K. Jeberla, “Challenges in Adopting Continuous Delivery and DevOps in a Globally Distributed Product Team: A Case Study of a Healthcare Organization,” in 2019 ACM/IEEE 14th International Conference on Global Software Engineering (ICGSE), IEEE, May 2019, pp. 30–34. doi: 10.1109/ICGSE.2019.00020.

S. Wan, X. Li, Y. Xue, W. Lin, and X. Xu, “Efficient computation offloading for Internet of Vehicles in edge computing-assisted 5G networks,” J Supercomput, vol. 76, no. 4, pp. 2518–2547, Apr. 2020, doi: 10.1007/s11227-019-03011-4.

C. Richardson, Microservices patterns: with examples in Java. Simon and Schuster, 2018.

P. Le Noac’h, A. Costan, and L. Bouge, “A Performance Evaluation of Apache Kafka in Support of Big Data Streaming Applications,” in 2017 IEEE International Conference on Big Data (Big Data), IEEE, pp. 4803–4806. doi: 10.1109/BigData.2017.8258548.

“Apache Kafka.” [Online]. Available: https://kafka.apache.org/

L. Tan et al., “Toward Real-Time and Efficient Cardiovascular Monitoring for COVID-19 Patients by 5G-enabled Wearable Medical Devices: A Deep Learning Approach”, doi: 10.1007/s00521-021-06219-9.

“Apache Flink.” [Online]. Available: https://flink.apache.org/

“Redis.” Accessed: Nov. 10, 2022. [Online]. Available: https://redis.io/

S. B. Overdijkink, A. V Velu, A. N. Rosman, M. D. M. Van Beukering, M. Kok, and R. P. M. Steegers-Theunissen, “The usability and effectiveness of mobile health technology–based lifestyle and medical intervention apps supporting health care during pregnancy: systematic review,” JMIR Mhealth Uhealth, vol. 6, no. 4, p. e8834, 2018.

K. Moulaei, A. Sheikhtaheri, Z. Ghafaripour, and K. Bahaadinbeigy, “The Development and Usability Assessment of an mHealth Application to Encourage Self-Care in Pregnant Women against COVID-19,” J Healthc Eng, vol. 2021, 2021.

B. Martinez et al., “mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial,” Reprod Health, vol. 15, no. 1, pp. 1–12, 2018.

S. Newman, Building microservices. “ O’Reilly Media, Inc.,” 2021.

X. Li, Y. Lu, X. Fu, and Y. Qi, “Building the Internet of Things platform for smart maternal healthcare services with wearable devices and cloud computing,” Future Generation Computer Systems, vol. 118, pp. 282–296, May 2021, doi: 10.1016/j.future.2021.01.016.

I. Marin, N. Goga, and A. Doncescu, “Security of an Electronic Heal Thcare System which Facilitates the Detection of Preeclampsia Through a Smart Bracelet,” in 2018 10th International Conference on Electronics, Computers and Artificial Intelligence (ECAI), IEEE, pp. 1–6.

C. Esposito, A. Castiglione, C. A. Tudorica, and F. Pop, “Security and Privacy for Cloud-Based Data Management in the Health Network Service Chain: A Microservice Approach,” IEEE Communications Magazine, vol. 55, no. 9, 2017, doi: 10.1109/MCOM.2017.1700089.

D. Surya Sai Venkatesh and S. Agarwal, “Data Access Pattern Recommendations for Microservices Architecture,” in 2022 IEEE 15th International Conference on Cloud Computing (CLOUD), IEEE, pp. 241–243. doi: 10.1109/CLOUD55607.2022.00044.

M. Rizki, A. N. Fajar, and A. Retnowardhani, “Designing Online Healthcare Using DDD in Microservices Architecture,” in Journal of Physics: Conference Series, doi: 10.1088/1742-6596/1898/1/012010.

A. Adi Pranata, N. Selviandro, and M. Adrian, “Analysis and Implementation of Presenter Layer on MVC Architecture iOS Application Development∗,” in 2022 The 5th International Conference on Software Engineering and Information Management (ICSIM), New York, NY, USA: ACM, Jan. 2022, pp. 82–86. doi: 10.1145/3520084.3520097.

R. P. Duarte, C. A. S. Cunha, and V. N. N. Alves, “Mobile Application for Real-Time Food Plan Management for Alzheimer Patients through Design-Based Research,” Future Internet, vol. 15, no. 5, May 2023, doi: 10.3390/fi15050168.

A. Saavedra, Y. Castillo, and V. Villarreal, “Mobile Application for the Monitoring of Patients with Diabetes Problems through Devices Based on Spectrophotometry,” in 2019 7th International Engineering, Sciences and Technology Conference (IESTEC), IEEE, pp. 619–624. doi: 10.1109/IESTEC46403.2019.00116.

V. Villarreal, M. Nielsen, and M. Samudio, “Sensing and Storing the Blood Pressure Measure by Patients through a Platform and Mobile Devices,” vol. 18, no. 6, p. 1805.

J. Brooke, “SUS: a retrospective,” J Usability Stud, vol. 8, no. 2, pp. 29–40, 2013.

B. Laugwitz, T. Held, and M. Schrepp, “Construction and Evaluation of a User Experience Questionnaire,” 2008, pp. 63–76. doi: 10.1007/978-3-540-89350-9_6.

I. Diáz-Oreiro, G. López, L. Quesada, and L. A. Guerrero, “UX Evaluation with Standardized Questionnaires in Ubiquitous Computing and Ambient Intelligence: A Systematic Literature Review,” Advances in Human-Computer Interaction, vol. 2021. Hindawi Limited, 2021. doi: 10.1155/2021/5518722.

[1]

M. I. Nielsen Pimentel, V. Villarreal, L. E. Muñoz Arracera, J. A. González Gómez, and D. Domínguez Perez, “Toward Safer Pregnancies: Usability evaluation of a prototype application for monitoring and controlling hypertensive disorders in pregnancy”, ing. Solidar, vol. 19, no. 3, pp. 1–36, Dec. 2023, doi: 10.16925/2357-6014.2023.03.10.

Download Citation

This work is licensed under a Creative Commons Attribution 4.0 International License.

Cession of rights and ethical commitment

As the author of the article, I declare that is an original unpublished work exclusively created by me, that it has not been submitted for simultaneous evaluation by another publication and that there is no impediment of any kind for concession of the rights provided for in this contract.

In this sense, I am committed to await the result of the evaluation by the journal Ingeniería Solidaría before considering its submission to another medium; in case the response by that publication is positive, additionally, I am committed to respond for any action involving claims, plagiarism or any other kind of claim that could be made by third parties.

At the same time, as the author or co-author, I declare that I am completely in agreement with the conditions presented in this work and that I cede all patrimonial rights, in other words, regarding reproduction, public communication, distribution, dissemination, transformation, making it available and all forms of exploitation of the work using any medium or procedure, during the term of the legal protection of the work and in every country in the world, to the Universidad Cooperativa de Colombia Press.

Issue

Vol. 19 No. 3 (2023)

Published

2023-12-30

Downloads

PDF

Metrics

Metrics Loading ...

https://plu.mx/plum/a/?doi=10.16925/2357-6014.2023.03.10