Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion

Background Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. Objective To describe SmartLoss, a semiautomated mHealth platform for weight loss. Methods We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Results Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight Management Suite, a professionally programmed platform that facilitates treatment fidelity and the ability to customize interventions and disseminate them widely. Conclusions SmartLoss functions as a virtual weight management clinic that relies upon empirical weight loss research and behavioral theory to promote behavior change and weight loss.

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Integrating mobile technology with routine dietetic practice: the case of myPace for weight management

Proceedings of The Nutrition Society ◽

10.1017/s0029665115000105 ◽

2015 ◽

Vol 74 (2) ◽

pp. 125-129 ◽

Cited By ~ 8

Author(s):

Michelle Harricharan ◽

Raymond Gemen ◽

Laura Fernández Celemín ◽

David Fletcher ◽

Anne E. de Looy ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Mobile Phone ◽

Weight Management ◽

Behaviour Change ◽

Mobile Technology ◽

Health Professionals ◽

Change Theory ◽

Care Practice ◽

Behaviour Change Theory

The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner–patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

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Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved

Obesity Facts ◽

10.1159/000520217 ◽

2021 ◽

pp. 1-7

Author(s):

Liesbet Trenson ◽

Sander Trenson ◽

Falco van Nes ◽

Carolien Moyson ◽

Matthias Lannoo ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Weight Management ◽

Real World ◽

Subcutaneous Administration ◽

Maximum Tolerated Dose ◽

Significant Weight Loss ◽

Additional Weight ◽

Obstructive Sleep ◽

Daily Dose

Introduction: Obesity is a global health challenge, and pharmacologic options are emerging. Once daily subcutaneous administration of 3 mg liraglutide, a glucagon like peptide-1 analogue, has been shown to induce weight loss in clinical trials, but real-world effectiveness data are scarce. Methods: It is a single-centre retrospective cohort study of patients who were prescribed liraglutide on top of lifestyle adaptations after multidisciplinary evaluation. In Belgium, liraglutide is only indicated for weight management if the BMI is >30 kg/m2 or ≥27 kg/m2 with comorbidities such as dysglycaemia, dyslipidaemia, hypertension, or obstructive sleep apnoea. No indication is covered by the compulsory health care insurance. Liraglutide was started at 0.6 mg/day and uptitrated weekly until 3 mg/day or the maximum tolerated dose. Treatment status and body weight were evaluated at the 4-month routine visit. Results: Between June 2016 and January 2020, liraglutide was prescribed to 115 patients (77% female), with a median age of 47 (IQR 37.7–54.0) years, a median body weight of 98.4 (IQR 90.0–112.2) kg, a BMI of 34.8 (IQR 32.2–37.4) kg/m2, and an HbA1c level of 5.6%. Five (4%) patients did not actually initiate treatment, 9 (8%) stopped treatment, and 8 (7%) were lost to follow-up. At the 4-month visit, the median body weight had decreased significantly by 9.2% to 90.8 (IQR 82.0–103.5) kg (p < 0.001). Patients using 3.0 mg/day (n = 60) had lost 8.0 (IQR 5.8–10.4) kg. The weight loss was similar (p = 0.9622) in patients that used a lower daily dose because of intolerance: 7.4 (IQR 6.2–9.6) kg for 1.2 mg (n = 3), 7.8 (IQR 4.1–7.8) kg for 1.8 mg (n = 16), and 9.0 (IQR 4.8–10.7) kg for 2.4 mg/day (n = 14). Weight loss was minimal if liraglutide treatment was not started or stopped prematurely (median 3.0 [IQR 0.3–4.8] kg, p < 0.001, vs. on treatment). Further analysis showed an additional weight reduction of 1.8 kg in the patients that had started metformin <3 months before the start of liraglutide (p < 0.001). The main reasons for liraglutide discontinuation were gastrointestinal complaints (n = 5/9) and drug cost (n = 2/9). Conclusion: In this selected group of patients, the majority complied with liraglutide treatment over the initial 4-month period and achieved a significant weight loss, irrespective of the maximally tolerated maintenance dose. Addition of metformin induced a small but significant additional weight loss.

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SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1522 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Zoe Rock ◽

Juliana Chen ◽

Joanna Jaques ◽

Bernard L Champion ◽

Reginald V Lord ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Weight Management ◽

Exercise Physiology ◽

Body Weight Loss ◽

Total Body Weight ◽

Management Interventions ◽

Co Morbidity ◽

Total Body ◽

Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

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Assessing the Effectiveness and Acceptability of a Personalized Mobile Phone App in Improving Adherence to Oral Hygiene Advice in Orthodontic Patients: Protocol for a Feasibility Study and a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/18021 ◽

2021 ◽

Vol 10 (1) ◽

pp. e18021

Author(s):

Mohammad Owaise Sharif ◽

Jonathon Timothy Newton ◽

Susan J Cunningham

Keyword(s):

Health Care ◽

Randomized Controlled Trial ◽

Behavior Change ◽

Mobile Phone ◽

Mobile Phones ◽

Orthodontic Treatment ◽

Controlled Trial ◽

Phase 1 ◽

Adherence To Treatment ◽

Randomized Controlled

Background Orthodontic treatment is a common health care intervention; treatment duration can be lengthy (2-3 years on average), and adherence to treatment advice is therefore essential for successful outcomes. It has been reported that up to 43% of patients fail to complete treatment, and there are currently no useful predictors of noncompletion. Given that the National Health Service England annual expenditure on primary-care orthodontic treatment is in excess of £200 million (US $267 million), noncompletion of treatment represents a significant inefficient use of public resources. Improving adherence to treatment is therefore essential. This necessitates behavior change, and interventions that improve adherence and are designed to elicit behavioral change must address an individual’s capability, opportunity, and motivation. Mobile phones are potentially an invaluable tool in this regard, as they are readily available and can be used in a number of ways to address an individual’s capability, opportunity, and motivation. Objective This study will assess the effectiveness and acceptability of a personalized mobile phone app in improving adherence to orthodontic treatment advice by way of a randomized controlled trial. Methods This study will be conducted in 2 phases at the Eastman Dental Hospital, University College London Hospitals Foundation Trust. Phase 1 is feasibility testing of the My Braces app. Participants will be asked to complete the user version of the Mobile Application Rating Scale. The app will be amended following analysis of the responses, if appropriate. Phase 2 is a randomized controlled trial to test the effectiveness and acceptability of the My Braces app. Results This study was approved by the London – Bloomsbury Research Ethics Committee on November 5, 2019 (reference 19/LO/1555). No patients have been recruited to date. The anticipated start date for recruitment to phase 1 is October 2020. Conclusions Given the availability, affordability, and versatility of mobile phones, it is proposed that they will aid in improving adherence to treatment advice and hence improve treatment completion rates. If effective, the applicability of this methodology to developing behavior change/modification interventions and improving adherence to treatment across health care provides an exciting opportunity. Trial Registration ClinicalTrials.gov NCT04184739; https://clinicaltrials.gov/ct2/show/NCT04184739 International Registered Report Identifier (IRRID) PRR1-10.2196/18021

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Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000659 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000659 ◽

Cited By ~ 2

Author(s):

Shaheen Tomah ◽

Noor Mahmoud ◽

Adham Mottalib ◽

David M Pober ◽

Mhd Wael Tasabehji ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Body Weight ◽

Blood Glucose ◽

Weight Management ◽

Average Frequency ◽

Baseline Body Mass Index ◽

Self Monitoring ◽

Median Change

ObjectiveWe evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.Research design and methodsWe conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1–2.9) times/day, 3.4 (3–3.9) times/day, and 5 (4–7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.ResultsParticipants in the highest tertile achieved a median change (IQR) in body weight of −10.4 kg (−7.6 to −14.4 kg) compared with −8.3 kg (−5.2 to −12.2 kg), and −6.9 kg (−4.2 to −8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of −1.25% (−0.6 to −3.1%) compared with −0.8% (−0.3% to −2%) and −0.5% (−0.2% to −1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.ConclusionsIncreased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.

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Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x16630846 ◽

2016 ◽

Vol 23 (2) ◽

pp. 263-272 ◽

Cited By ~ 21

Author(s):

Erik A Willis ◽

Amanda N Szabo-Reed ◽

Lauren T Ptomey ◽

Felicia L Steger ◽

Jeffery J Honas ◽

...

Keyword(s):

Systematic Review ◽

Social Networks ◽

Weight Loss ◽

Body Weight ◽

Weight Management ◽

Online Social Networks ◽

Disease Risk ◽

Primary Source ◽

Outcome Data ◽

Management Interventions

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990–November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

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Outcomes of weight management in obese pet dogs: what can we do better?

Proceedings of The Nutrition Society ◽

10.1017/s0029665116000185 ◽

2016 ◽

Vol 75 (3) ◽

pp. 398-404 ◽

Cited By ~ 3

Author(s):

Alexander J. German

Keyword(s):

Weight Loss ◽

Clinical Research ◽

Weight Management ◽

Health Benefits ◽

End Points ◽

Pet Dogs ◽

Welfare Issue ◽

Successful Weight Loss ◽

The Individual ◽

Current Weight

Obesity is arguably the biggest health and welfare issue affecting pet dogs. Although successful weight loss has health benefits, current strategies are far from ideal. Many obese dogs that start a weight programme fail to lose weight, or subsequently regain the weight they have lost. Given that current weight loss strategies are not perfect, clinicians need to focus carefully on tailoring the programme, perhaps setting a pragmatic target for weight loss, so as to ensure the benefits are maximised. This review will summarise key findings from recent clinical research into pet obesity, and present a framework for improving success, by better tailoring weight management regimens and end points to the individual.

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A Mobile Phone App Designed to Support Weight Loss Maintenance and Well-Being (MotiMate): Randomized Controlled Trial (Preprint)

10.2196/preprints.12882 ◽

2018 ◽

Author(s):

Emily Brindal ◽

Gilly A Hendrie ◽

Jill Freyne ◽

Manny Noakes

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Randomized Controlled Trial ◽

Body Weight ◽

Food Intake ◽

Mobile Phone ◽

Controlled Trial ◽

Well Being ◽

Full Version ◽

Randomized Controlled

BACKGROUND Few people successfully maintain lost weight over the longer term. Mobile phones have the potential to deliver weight loss management programs that can encourage self-monitoring while also providing some behavioral therapy to assist users in developing personal skills that may be necessary for improved longer term weight loss maintenance. OBJECTIVE The aim of this study was to evaluate a program supporting weight maintenance, which uses a behaviorally based mobile phone app to manage weight, food, exercise, mood, and stress. METHODS In a randomized controlled trial over 24 weeks, the full version of the app (MotiMate) was compared with a control app (monitoring only; excluding mood and stress) for its effect on weight, diet, and psychological well-being. Both apps had the same visual appearance and were designed to deliver all intervention content without face-to-face contact. The control version included features to track weight, food intake, and exercise with limited feedback and no encouraging/persuasive features. The intervention app included more persuasive and interactive features to help users track their weight, food intake, and physical activity and prompted users to enter data each day through notifications and included a mood and stress workshopping tool. Participants were recruited through advertising and existing databases. Clinic visits occurred at baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks. At all visits, the clinical trial manager recorded body weight, and participants then completed a computer-delivered survey, which measured psychological and lifestyle outcomes. Objective app usage data were recorded throughout the trial. RESULTS A total of 88 adults who had lost and maintained at least 5% of their body weight within the last 2 years were randomized (45 MotiMate and 43 control). Overall, 75% (66/88) were female, and 69% (61/88) completed week 24 with no differences in dropout by condition (χ21, 87=0.7, P=.49). Mixed models suggested no significant changes in weight or psychological outcomes over 24 weeks regardless of condition. Of 61 completers, 53% (32/61) remained within 2% of their starting weight. Significant increases occurred over 24 weeks for satisfaction with life and weight loss self-efficacy regardless of app condition. Diet and physical activity behaviors did not vary by app or week. Negative binomial models indicated that those receiving the full app remained active users of the app for 46 days longer than controls (P=.02). Users of the full version of the app also reported that they felt more supported than those with the control app (P=.01). CONCLUSIONS Although some aspects of the intervention app such as usage and user feedback showed promise, there were few observable effects on behavioral and psychological outcomes. Future evaluation of the app should implement alternative research methods or target more specific populations to better understand the utility of the coping interface. CLINICALTRIAL Australia New Zealand Clinical Trials Registry ACTRN12614000474651; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366120

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Can Weight Watchers (WW) Help Address Maternal Obesity? An Audit of Weight Change in Women of Childbearing Age and Mothers-To-Be, Referred into a Commercial Slimming Programme

Maternal and Child Health Journal ◽

10.1007/s10995-021-03204-5 ◽

2021 ◽

Author(s):

Karen Tocque ◽

Lynne Kennedy

Keyword(s):

Weight Loss ◽

Body Weight ◽

Weight Management ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Initial Body Weight ◽

Intention To Treat ◽

Weight Watchers ◽

Median Weight Loss ◽

Management Services

Abstract Objectives The scale of overweight and obesity amongst women of childbearing age or mothers to be, living in Wales, places a considerable burden on the NHS and public health. High BMI (over 30) during pregnancy increases the health risks for mother and baby. Policy advice recommends weight management services are available to help women lose weight before and whilst planning pregnancy. In parts of Wales, NHS partnerships with commercial companies provide weight management services for women considering or planning pregnancy. This study evaluates whether an established referral Weight Watchers (WW) programme, known to be effective in adults in England, can help mothers-to-be living in North Wales lose weight. Methods Analysis used routine data from 82 referrals to WW between June 2013 and January 2015. Participants received a referral letter inviting them to attend face-to-face group workshops combined with a digital experience. The programme encompassed healthy eating, physical activity and positive mind-set. Trained WW staff measured bodyweight before, during and at 12 weeks. On entry to the course, participants had a median age of 31.4 years (interquartile range (IQR) 28–34) with a median BMI of 36.8 kg/m2 (IQR 33.3–43.7). Results Women completing the course (n = 34) had a median weight loss of 5.65 kg (IQR 0.45–10.85), equating to 5.7% (SD 3.46) of initial body weight. Intention-to-treat analysis (last observation carried forward), which included lapsed courses n = 66, showed a median weight loss of 3.6 kg (IQR − 2.53 to 9.73), equating to 3.7% (SD 3.62) of initial body weight. Overall, there was significant weight loss during the WW programme (Wilcoxon signed rank test Z = − 6.16; p < 0.001). Weight loss was significantly correlated with the number of workshops attended (Spearman correlation coefficient 0.61 p < 0.001). The proportion of all 82 participants (intention to treat, baseline observation carried forward) that achieved a weight loss of ≥ 5% initial weight was 30.5%. Conclusions for Practice Referral of obese mothers-to-be into WW can successfully achieve short-term weight loss, at or above 5%, in approximately one third of participants. The dose–response effect supports a causal inference. Successful weight loss at this critical life stage may provide women with the necessary motivation to initiate weight loss for healthy pregnancy, however further research is required.

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What does it mean for a woman to have access to a phone in India? Implications for the development of mHealth interventions for maternal health (Preprint)

10.2196/preprints.34852 ◽

2021 ◽

Author(s):

Ruchita S. Pendse ◽

Alison M. El Ayadi ◽

Preetika Sharma ◽

Alka Ahuja ◽

Darshan Hosapatna Basavarajappa ◽

...

Keyword(s):

Mobile Phone ◽

Mobile Phones ◽

Mobile Health ◽

Gender Gap ◽

Digital Health ◽

Family Members ◽

Postpartum Care ◽

Future Research ◽

Pregnancy And Postpartum ◽

Phone Access

BACKGROUND As mobile phone uptake in India continues to grow, there is continued interest in mobile platform-based interventions for health education among other topics. Existing studies demonstrate a significant gender gap in mobile phone access, and suggest women’s access to mobile phones is constrained by economic and diverse social barriers. Pregnancy and postpartum care is one of many targets for mobile health (mHealth) interventions which particularly rely on women’s access to and facility with mobile phone use. OBJECTIVE This paper describes dynamics and patterns of women’s mobile phone access and use among both phone owners and non-owners, including potential barriers to mHealth participation. METHODS Mixed-methods data were obtained from two different surveys (n=102 and n=29), two sets of in-depth interviews (n=20 and 29), and weekly data collection obtained in preparation for or within the pilot of an mHealth postpartum care intervention in rural Punjab in July 2020-February 2021. RESULTS A majority of women owned their own phone, though about half (52%) of phone owners still reported sharing their phone with other family members. Sharing a phone with female family members typically allowed for better access than sharing with male family members. Some households have strict preferences against daughters-in-law having phones, or otherwise significantly restrict or control women’s phone access. Others reported concerns about phone use-related health hazards during pregnancy or postpartum for mother and infant. CONCLUSIONS These findings suggest significant variability and nuance to what is meant by women’s phone ownership and access given the numerous additional constraints on their use of phones, particularly during pregnancy and postpartum. Future research and mHealth interventions should probe these domains to better understand these dynamics governing women’s access, use, and fluency with mobile phones to optimally design mHealth interventions. mHealth, mobile health, digital health, India, pregnancy, pregnant women, postpartum, postpartum care INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.34087

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