Making Myana ("Mothers, You Are Not Alone"): An Equity-Focused Process for Developing a Postpartum Support App.

Introduction: Many digital tools are available to support healthy pregnancies. Far fewer focus on the postpartum period or have the explicit goal of reducing poor or inequitable maternal health outcomes. Yet, many pregnancy-related complications occur up to a year after labor and delivery. Here, we outline a healthequity-centered process, using multiple phases of data collection, which informed our design decisions when developing a comprehensive postpartum support app, Myana ("Mothers, you are not alone"). Methods: Drawing on a behavioral decision research approach and grounded in principles for developing equity-focused digital reproductive health tools, we iteratively designed and tested the Myana app. Our data collection included qualitative interviews, focus groups, and evaluations of an interactive experience prototype and app wireframes. Results: To illustrate our process, we highlight two unique features of Myana intended to address health inequities: a symptom triaging feature ("The Healing Check-in") and a tailored educational hub ("The Learning Center"). Results from our iterative development process shaped how we asked about and responded to symptoms reported in the Healing Check-in, the topics and framing of curated content in the Learning Center, the cadence of expected interaction with features in the app, as well as the app's overall tone and visual design. Discussion: We created a postpartum support app to help birthing parents make informed decisions about their health and well-being in the year postpartum, with the larger goal of improving health outcomes. The iterative design and development process integrated clinical and community perspectives while intentionally centering health disparities. This approach represents a new model for developing digital supports to supplement the formal healthcare system.