Table 3 Additional quotes from all three groups (preconception, pregnancy and postbirth) for each theme and subtheme.

From: Personalization and localization as key expectations of digital health intervention in women pre- to post-pregnancy

Themes & Subthemes

Preconception

Pregnancy

Postbirth

Personalized Journey

Two-way interactivity

Data-driving personalized interaction

“If I can key in the number of hours I sleep, the type of exercise I do, what I eat… they will generate like a checklist of things that you need to eat… to boost up the health.” -Participant 5

“It would be nice to track for example, my weight loss - this is how much I did weigh, and these are the results [for] glucose levels, glucose tests, urine tests… because I lost 18 pounds in the first month, I am wondering should I be concerned.” -Participant 6

“The personalization must grow as our baby grows. So [with each] milestones achieved, maybe suggestions of activities to do at home, places to bring them to.” -Participant 11

Right timing

“Just show me whatever information is relevant to me now. Don’t show me what to do when you’re pregnant… If I were to use an app, I’d rather just use the stuff that’s relevant to me.”

-Participant 35

“They tell you to go for activities which are less strenuous. During the first trimester, try not to exercise too much. To a certain extent, there should be a bit more information about what exercises can be done during the pregnancy itself.” -Participant 33

“There’s chat for the [app], so it’ll send out notifications from other mummies. It starts to give out notifications [that is] unrelated [so,] you don’t want to see at all. I find it quite annoying.”

-Participant 17

Journey organization

Milestone indication

“Maybe you can… tell people like okay, now you are at like 31 years old, you should be doing this [fertility] check if you have not done it within the past 2 years or 3 years. So, it serves as a reminder for them.”

-Participant 39

“It would be useful to show how the pregnancy is at every week… like what you can see at 28 weeks of pregnancy… how the pregnancy is progressing.”

-Participant 29

“Their milestones like gross motor milestones, fine mental milestones are not consolidated in one app… don’t think I have seen it in a specific place. Maybe that would be helpful for parents who are not aware.” -Participant 26

Privacy trade-off

Extent of information collection

“I would like [feedback]. What I think I need, may not be what I actually need. But if you are talking about algorithm-based then it’s going to be very difficult, and there is a lot of data sharing involved. -Participant 41

“[Personalization will be great, but I don’t know whether it is going to be possible and how much of a personal information I need to give in order for it to be personalized on me for me.”

-Participant 31

“Personally, because I’m [have a] scientific background, I know that these factors (referring to age and due date) play a very important role in the health of the mother and the baby… So, I don’t mind giving [that] information.”

-Participant 44

Trust in government and hospitals

“Must see which organization, if it’s the government, then it’s okay. If it’s a private one, then no, [I] won’t.”

-Participant 36

“At the end of the day, they can give you the information and I will decide… at least it’s like having someone to [find] the information. Okay, this is what [the app] found and I will literally follow the healthcare.” -Participant 31

“It depends for what purposes, how, and who the data goes to, how it’s being stored. Let’s say it’s for Singpass, I would give because it’s a governmental database and it’s a reliant source.”

-Participant 8

Localization of DHI

Local health-related resources

Access to local healthcare resources

“Notifications… with a localized context. Like say, are you like a homemaker…. maybe you can have like express therapy [for] half an hour, next door.” -Participant 12

“People in your community or area that’s specialize in pre- [or] post-natal would be good. Okay, you’re in the west of Singapore, here’s a great therapist or counsellor [or] physio.” -Participant 7

“It was a Saturday [and] I couldn’t find information on which clinic I should bring him to for an x-ray. It took me so long to find the information because the polyclinic was not available… on weekend[s].” -Participant 24

Understanding the local healthcare process

“Let’s say if I’m pregnant, I have no idea what to do. Should I book an appointment with a doctor? NUH (local public hospital) or private? Which direction should I go to? Is it find a doctor first? Or choose a hospital first? So these kind of things I’m not too sure.” -Participant 30

“When should I like book my maternity tour with [the] private hospital that I want? When should I even check into the hospital? So, things like appointment scheduler would be helpful and for Singapore.” -Participant 4

“There’s really quite a lot of stuff that you have to do after you have a baby, such as churning out the birth cert, applying for your baby bonus, all that. I wonder if there could be a one-stop app to kind of guide you through all the things that you have to do because being a parent can be quite overwhelming and you might not have the headspace to think about all these things.”

-Participant 23

Localized lifestyle guidance

“I don’t use [apps], but I will go through to see what type of Traditional Chinese Medicine they recommend, which gynae they go to [and] what type of journey that they had.” -Participant 36

“Sometimes I [wonder], can I eat black sesame? Online they only tell you about sesame seeds [but] they don’t tell you about black sesame paste… so you don’t know whether is okay.” -Participant 15

“Having a more localized version that’s developed by a team that is either based here or knows the food here will help… like I try to type char kway teow (local dish), I can find it. Versus like say a Google Health app, that will be less likely… it’s very hard to find certain food that we eat here.” -Participant 18

Hearing from a local voice

Connecting with a community through personal anecdotes

“I’m all for [connecting with others], if only people would be willing to talk about it… I think, this kind of connection can help heal [because] you [don’t] need to struggle alone, that’s what your app is supposed to do.”

-Participant 32

“I’d like to just be able to talk to moms about like getting the vaccine… I was able to text the group [from school and] that piece of reassurance of 3 moms responded right away and said - Oh my gosh, I’m thinking the same thing just today.” -Participant 6

“When the mummies chat on [an] issue, they [will] ask - what do you do? I [will] tell my point of view and other mummies will suggest so, we pick up from there… So, when I told the mummy’s group [about my daughter’s cough], they said why not you try to go over the counter and purchase [cough medication] … So, I bought one and keep it at home.” -Participant 42