The impact of mHealth interventions on health-promoting behaviors in pregnant women: a randomized clinical trial

BACKGROUND: Health-promoting behaviors are crucial for maternal and fetal well-being during pregnancy, yet many women face barriers to adopting these practices. Mobile health technologies offer innovative solutions by providing personalized interventions. This study evaluated the effectiveness of a comprehensive mHealth application in promoting health behaviors among pregnant women. METHODS: In a two-arm, parallel-group, randomized controlled trial, 80 pregnant women aged 18-45 years with gestational age between 18 and 36 weeks were recruited from prenatal clinics affiliated with Mashhad University of Medical Sciences, Mashhad, Iran between May and September 2023. Participants were randomly assigned (1:1) using computer-generated sequence and centralized allocation concealment to either an intervention group receiving the mHealth app or a control group receiving standard prenatal care. The app, developed by healthcare professionals, provided multimedia resources and step-by-step guidance on health responsibility, exercise, nutrition, spiritual improvement, interpersonal relations, and stress management. Data were collected at baseline and after four weeks using the Health Promoting Lifestyle Profile II. Statistical analyses, following the intention-to-treat principle, included analysis of covariance to assess the intervention effect while controlling for baseline scores, independent t-test, and chi-square test using SPSS Version 22. Missing data were addressed using Multiple Imputation. RESULTS: Both groups were homogeneous in terms of personal and obstetric characteristics at baseline. The intervention group exhibited significant improvements in health-promoting behaviors compared to the control group, with higher HPLP-II scores (mean difference: 29.5, P = 0.004). Significant improvements were observed across all HPLP-II subscales, including health responsibility, exercise, nutrition, spiritual improvement, interpersonal relations, and stress management. The effectiveness of intervention was consistent across various demographic subgroups. CONCLUSIONS: The mHealth intervention significantly enhanced health-promoting behaviors among pregnant women, demonstrating the practical application of mHealth tools in supporting healthier lifestyles during pregnancy. These findings suggest that mHealth technologies can be effectively integrated into prenatal care to improve maternal and fetal outcomes. Future research should explore the long-term impacts and broader applicability of such interventions across diverse populations. TRIAL REGISTRATION: The trial was registered at https://irct.behdasht.gov.ir (identifier: IRCT ID: IRCT20180412039276N2) on May 23, 2022.