Personalized and Culturally Tailored Features of Mobile Apps for Gestational Diabetes Mellitus and Their Impact on Patient Self-Management: Scoping Review (Preprint)

BACKGROUND Gestational diabetes mellitus (GDM) is an increasingly common high-risk pregnancy condition requiring intensive daily self-management, placing the burden of care directly on the patient. Understanding personal and cultural differences among patients is critical for delivering optimal support for GDM self-management, particularly in high-risk populations. Although mobile apps for GDM self-management are being used, limited research has been done on the personalized and culturally tailored features of these apps and their impact on patient self-management. OBJECTIVE This scoping review aims 1) to determine the extent to which GDM mobile apps used in published studies provide personalized and culturally tailored features for self-management support for patients, and 2) to assess the impact of these GDM mobile apps with personalized and culturally tailored features on patient self-management. METHODS We examined English-language peer-reviewed articles published between October 2016 and May 2023 from PubMed, CINAHL, PsycINFO, ClinicalTrials.gov, Proquest Research Library, and Google Scholar using search terms related to digital tools, diabetes, pregnancy, and cultural tailoring. We reviewed eligible articles and extracted data using the Arskey and O’Malley methodological framework. RESULTS Our search yielded a total of 1772 articles after the removal of duplicates and 158 articles for full-text review. A total of 21 articles that researched 15 GDM mobile apps were selected for data extraction. Our results demonstrated the stark contrast between the number of GDM mobile apps with personalized features for the individual user (all 15 mobile apps) and those culturally tailored for a specific population (only 3 of the 15 mobile apps). Our findings showed that GDM mobile apps with personalized and culturally tailored features were perceived to be useful to patients and had the potential to improve patients’ adherence to glycemic control and nutrition plans. CONCLUSIONS There is a strong need for increased research and development to foster the implementation of personalized and culturally tailored features in GDM mobile apps for self-management designed for patients from diverse backgrounds and ethnicities. Personalized and culturally tailored features have the potential to serve the unique needs of patients more efficiently and effectively than generic features alone, however their impacts still need to be adequately studied. Recommendations for future research include examining the cultural needs of different ethnicities in the context of GDM self-management, particularly in the increasingly diverse United States population, conducting participatory-based research with these groups, and designing human-centered mHealth solutions for both patients and providers.