Evidence map›Paper›PMID 42849035›Full record

ArticleJournal of medical Internet research2026

Feasibility and Usability of a Digital Perinatal Navigator for High-Risk Pregnancies: Mixed Methods Study.

Michelle Foerstel, Kristina Killinger, Mitho Mueller, Verena Engel, Katrin Schlobohm, Anna Sophie Scholz, Maren Goetz, Armin Bauer, Markus Wallwiener, Michael Abou-Dakn and 3 more

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Article in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Michelle Foerstel *Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Baden-Wurttemberg, Germany.ORCID https://orcid.org/0009-0000-6787-4392
Kristina Killinger *Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Baden-Wurttemberg, Germany.ORCID https://orcid.org/0009-0008-8469-8405
Mitho MuellerDepartment of Psychology, Ludwig-Maximilians-Universität München, München, Germany.ORCID https://orcid.org/0000-0002-8431-540X
Verena EngelInstitute for Communication and Assessment Research, Heidelberg, Germany.ORCID https://orcid.org/0009-0007-1035-4274
Katrin SchlobohmInstitute Women's Health GmbH, Tübingen, Germany.ORCID https://orcid.org/0009-0009-9014-3569
Anna Sophie ScholzDepartment of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Baden-Wurttemberg, Germany.ORCID https://orcid.org/0000-0002-3439-3872
Maren GoetzDepartment of Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, AL, Germany.ORCID https://orcid.org/0000-0002-3558-5542
Armin BauerInstitute Women's Health GmbH, Tübingen, Germany.ORCID https://orcid.org/0009-0006-2885-0965
Markus WallwienerDepartment of Gynecology, University Hospital Halle, Halle, Germany.ORCID https://orcid.org/0000-0003-3107-4160
Michael Abou-DaknDepartment of Obstetrics and Gynecology, St. Joseph's Hospital Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-3256-6282
Dorothea ScholleDepartment of Obstetrics and Gynecology, St. Joseph's Hospital Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-3256-6282
Ekkehard SchleussnerDepartment of Obstetrics, Jena University Hospital, Jena, Germany.ORCID https://orcid.org/0000-0003-1776-2178
Stephanie WallwienerDepartment of Obstetrics and Perinatal Medicine, University Hospital Halle, Halle, Germany.ORCID https://orcid.org/0000-0003-2045-650X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe journey to parenthood involves significant physical, emotional, and psychosocial changes. Mental health challenges impact both maternal and fetal health, potentially leading to obstetric complications and developmental risks for children. Access to needed perinatal support is often limited due to individual and structural barriers. Digital health solutions can offer opportunities to provide low-threshold, personalized, and scalable support. We developed a digital navigator offering personalized guidance and connecting users to relevant support services with interactive follow-ups to self-assess their well-being. However, evidence regarding the feasibility of digital solutions in high-risk patients is limited.

objectiveThis study aimed to assess the feasibility and usability of a digital perinatal navigator app designed to provide personalized support and connect individuals with high-risk pregnancies to relevant health and social services.

methodsConducted at University Women's Hospital Heidelberg, the study used convenience sampling for a 2-week app test phase. A convergent mixed methods design integrated qualitative interviews (n=30) with psychometric surveys (n=35). Analyses included thematic analysis of interviews, descriptive statistics, 2-tailed paired t tests, and Pearson correlations. Results were triangulated at the end to better understand barriers to use.

resultsParticipants (median age 33 years; median gestational age 30 weeks) reported moderate to high rates of stress, anxiety, and depressive symptoms. Usability ratings were excellent (median System Usability Scale [SUS] score 80, IQR 17.5; median mHealth App Usability Questionnaire [MAUQ] score 111, IQR 28). Knowledge of health service providers increased significantly (mean +1.2 points; P<.01), with modest improvements in use. Qualitative analysis revealed key success factors such as intuitive structure, trustworthy medical content, and personalized information. Technical disruptions, navigation challenges, limited personalization, and incomplete regional integration of health care services were reported as barriers.

conclusionsThe results indicate high feasibility and usability for our digital navigator in this high-risk population. The identified barriers are to be considered in the further development of the app and other perinatal digital care programs.

Indexed as

Mobile ApplicationsPerinatal CarePregnancy, High-RiskAdultDigital HealthFeasibility StudiesFemaleHumansPregnancyfeasibilityhealth service accessibilitymHealthmobile healthpatient-centered careperinatal careperinatal mental health

Identifiers

PMID42849035

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.