Impact of a Mobile Health Application on User Engagement and Pregnancy Outcomes Among Wyoming Medicaid Members

Abstract

Background:

Pregnancy and birth outcomes are a critical area of healthcare, yet negative outcomes like C-sections and preterm births remain widespread. Studies show that early and ongoing prenatal care can improve outcomes; however, in-person care is difficult to deliver in rural areas. This article examines the impact of mobile health technology on user engagement and birth outcomes in a Wyoming pilot study. The pilot did face some limitations; namely, the small app user group size and scant demographic information collected from users.

Materials and Methods:

Wyoming Medicaid contracted with Xerox State Healthcare to launch WYhealth Due Date Plus, a pregnancy application by Wildflower Health. Pregnant Medicaid members registering for the app and providing a Medicaid ID were assigned to the app user group (N = 85). The non-app user group consisted of other pregnant Medicaid members with delivery outcome records (N = 5,158). Downloads and utilization frequency were tracked to gauge user engagement. Among pregnant Medicaid members, data were collected on app usage and four outcomes of interest—6-month or more prenatal visit, C-section, low birth weight, and Neonatal Intensive Care Unit (NICU) admission—to examine the association between app use and pregnancy/birth outcomes. Chi-square tests were conducted to analyze associations. A Kolmogorov–Smirnov test was used to assess potential confounding.

Results:

Strong user engagement was observed with over 1,730 downloads. App users had a statistically significant association between app usage and completion of a 6-month or more prenatal visit (p = 0.022). There was a borderline significant association between app use and decreased incidence of low birth weight (p = 0.055). Maternal age was not a possible confounder.

Conclusions:

Preliminary data indicate that Due Date Plus attracted an engaged user base and that app usage was associated with improvements in prenatal visit completion and reduced incidence of low-birth weight delivery. These promising results suggest broader implementation and further study of mobile applications for prenatal support.