TY  - JOUR
AU  - Rizzi, Silvia
AU  - Pavesi, Maria Chiara
AU  - Moser, Alessia
AU  - Paolazzi, Francesca
AU  - Marchesoni, Michele
AU  - Poggianella, Stefania
AU  - Gadotti, Erik
AU  - Forti, Stefano
PY  - 2025
DA  - 2025/1/17
TI  - A Mindfulness-Based App Intervention for Pregnant Women: Qualitative Evaluation of a Prototype Using Multiple Case Studies
JO  - JMIR Form Res
SP  - e58265
VL  - 9
KW  - mindfulness
KW  - promoting well-being
KW  - pregnancy
KW  - eHealth
KW  - mHealth
KW  - mobile apps
KW  - development
KW  - usability
KW  - user-centered design
KW  - well-being
KW  - maternal health
KW  - digital health
KW  - intervention
KW  - design
KW  - preliminary testing
KW  - technology-based
KW  - interview
KW  - multidisciplinary approach
KW  - mother
KW  - women
KW  - WhatsApp
KW  - email
KW  - midwife
AB  - Background: Pregnancy is a complex period characterized by significant transformations. How a woman adapts to these changes can affect her quality of life and psychological well-being. Recently developed digital solutions have assumed a crucial role in supporting the psychological well-being of pregnant women. However, these tools have mainly been developed for women who already present clinically relevant psychological symptoms or mental disorders. Objective: This study aimed to develop a mindfulness-based well-being intervention for all pregnant women that can be delivered electronically and guided by an online assistant with wide reach and dissemination. This paper aimed to describe a prototype technology-based mindfulness intervention’s design and development process for pregnant women, including the exploration phase, intervention content development, and iterative software development (including design, development, and formative evaluation of paper and low-fidelity prototypes). Methods: Design and development processes were iterative and performed in close collaboration with key stakeholders (N=15), domain experts including mindfulness experts (n=2), communication experts (n=2), and psychologists (n=3), and target users including pregnant women (n=2), mothers with young children (n=2), and midwives (n=4). User-centered and service design methods, such as interviews and usability testing, were included to ensure user involvement in each phase. Domain experts evaluated a paper prototype, while target users evaluated a low-fidelity prototype. Intervention content was developed by psychologists and mindfulness experts based on the Mindfulness-Based Childbirth and Parenting program and adjusted to an electronic format through multiple iterations with stakeholders. Results: An 8-session intervention in a prototype electronic format using text, audio, video, and images was designed. In general, the prototypes were evaluated positively by the users involved. The questionnaires showed that domain experts, for instance, positively evaluated chatbot-related aspects such as empathy and comprehensibility of the terms used and rated the mindfulness traces present as supportive and functional. The target users found the content interesting and clear. However, both parties regarded the listening as not fully active. In addition, the interviews made it possible to pick up useful suggestions in order to refine the intervention. Domain experts suggested incorporating auditory components alongside textual content or substituting text entirely with auditory or audiovisual formats. Debate surrounded the inclusion of background music in mindfulness exercises, with opinions divided on its potential to either distract or aid in engagement. The target users proposed to supplement the app with some face-to-face meetings at crucial moments of the course, such as the beginning and the end. Conclusions: This study illustrates how user-centered and service designs can be applied to identify and incorporate essential stakeholder aspects in the design and development process. Combined with evidence-based concepts, this process facilitated the development of a mindfulness intervention designed for the end users, in this case, pregnant women. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2025/1/e58265
UR  - https://doi.org/10.2196/58265
DO  - 10.2196/58265
ID  - info:doi/10.2196/58265
ER  -