Document Type

Dissertation

Graduation Date

12-2025

Degree Name

Doctor of Public Health

First Committee Member

Dr. Ariane Rung

Second Committee Member

Dr. Chad Abresch

Third Committee Member

Dr. Holly Funkhouser-Cucuzzella

Fourth Committee Member

Dr. Nicole Kolm-Valdivia

Abstract

Background: Digital health interventions are increasingly integrated into health care delivery, yet limited evidence exists on how high-risk, low-income pregnant women engage with such tools. This convergent mixed-methods study examined patient and nursing perspectives on the use of digital health applications in the Improving Pregnancy Outcomes (IPO) program, a community-based initiative in Burlington County, New Jersey, relaunched in 2024.

Methods: IPO nursing staff from the Burlington County Health Department were invited to participate in a semi-structured questionnaire administered virtually. Patients enrolled in the re-implemented IPO program were contacted by phone and offered a survey to assess their experiences with the digital applications and the program overall.

Results: Of the 10 IPO nurses, 4 participated. Nurses generally perceived the applications as beneficial for promoting patient empowerment and postpartum preparedness, though they noted minor challenges, including advertisements and limited day-to-day integration. Since reimplementation, 21 patients enrolled in the program; 19 (90.5%) completed the survey. Among these, 13 downloaded at least one of the three offered applications. More than half of these users reported that the applications were useful (77%), convenient (92.3%), and easy to adopt (92.3%), though their impact on postpartum preparedness was less clear (54%). Moreover, a few patients described the content as overwhelming and repetitive at times. Overall, 89% of respondents expressed satisfaction with the IPO program.

Conclusion: Findings suggest that digital health applications are acceptable to both patients and providers in a community-based maternal health program serving vulnerable populations. While the tools were viewed positively, consolidating to a single application may reduce content burden and enhance usability. Future research should explore long-term postpartum outcomes and the role of digital tools in supporting maternal decision-making.

Available for download on Wednesday, December 16, 2026

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