Usability and acceptability of a mobile application prototype for managing hypertensive disorders of pregnancy: A mixed methods evaluation

Objective: Hypertensive disorders of pregnancy (HDP) contribute to maternal mortality and morbidity globally. Mobile health technologies may improve HDP management through patient education, facilitating patient-provider communication, and supporting blood pressure self-monitoring through tailored feedback and reminder prompts. Our objective was to understand the digital health needs of women with HDP from low-socioeconomic backgrounds. Methods: An interactive HDP management digital prototype was developed and evaluated through usability and acceptability testing. Participants included nine pregnant or postpartum women with diagnosed HDP and three maternal-fetal medicine specialists, recruited from two clinics in a predominantly low-income city, Newark, N.J., in 2024 The Technology Acceptance Model was used to guide the assessment of the prototype's acceptability and usability. Data were collected from interviews, a digital literacy questionnaire, and a system usability questionnaire, with quantitative data analyzed descriptively and qualitative data through content analysis. Results: The median gestational age among pregnant women was 22.0 (17.0, 29.0) weeks, with 89 % identifying as Black/African American. Most women (78 %) reported moderate or high digital health literacy. The mean System Usability score was 81 ± 17, indicating good usability. Three themes were identified: high acceptability and usability, the importance of tailored feedback, and the need for real-time provider-patient communication to support treatment decisions. Conclusions: These findings indicate a high acceptability and usability of a digital application for HDP management and home blood pressure monitoring among pregnant and postpartum women diagnosed with HDP and their providers in a low-income urban setting.