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Telemed J E Health. 2017 Nov;23(11):891-898. doi: 10.1089/tmj.2016.0242. Epub 2017 May 8.

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

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1 Wyoming Medicaid, Office of Health Care Financing , Cheyenne, Wyoming.
2 Wildflower Health , San Francisco, California.
3 Care and Quality Solutions, Xerox Healthcare Solutions , Cumming, Georgia .
4 Analytics Resource Center, Xerox Healthcare Solutions , Redmond, Washington.



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.


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.


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.


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.


birth outcomes; consumer health information; engagement; low birth weight; mobile health; pregnancy; prenatal care; telemedicine

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