ArticleBMC medical informatics and decision making2026
Applying a multi-level usability framework for evaluation of a pregnancy health promotion app.
Article in BMC medical informatics and decision making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Effects of internet-based supportive intervention on knowledge, pregnancy stress, fear of childbirth, and pregnancy outcomes in primiparas.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPregnancy mobile health (mHealth) applications provide educational support to expectant mothers; however, usability challenges—such as complex navigation, culturally misaligned medical terminology, and concerns about clinical reliability—can limit user engagement and trust. This study aimed to address these gaps by evaluating a culturally tailored pregnancy health promotion app for Iranian users using a structured multi-level usability framework.
methodsA three-level usability evaluation was conducted. Level 1 involved user-centered design assessment through focus groups with medical informatics experts and software developers, focusing on interface design, technical feasibility, and security. Level 2 comprised expert usability testing using think-aloud protocols with health specialists to identify interface, content, and performance issues. Level 3 involved real-world usability testing through a 10-day pilot study with pregnant women in their second or third trimester, using the user Mobile App Rating Scale (uMARS) and semi-structured interviews. Qualitative data were analyzed using conventional content analysis, while quantitative data were summarized using descriptive statistics. Findings across levels were integrated to generate comprehensive usability insights.
resultsLevel 1 analysis identified four key themes: app design principles, user retention factors, web-based platform advantages, and security considerations, emphasizing UI/UX optimization and cross-platform accessibility. Level 2 revealed three themes: interface usability, content quality, and technical performance with recommendations for improved navigation, visual hierarchy, and loading speed. Level 3 demonstrated high user satisfaction in real-world use, with qualitative themes centered on information trustworthiness, cultural alignment, and interface simplicity. Quantitatively, the app achieved a high mean uMARS score of 4.2 out of 5.0, indicating superior usability quality.
conclusionThis multi-level mixed-method evaluation highlights the value of integrating expert and end-user perspectives to generate actionable usability improvements. By balancing technical robustness, user-centered design, and cultural relevance, the proposed framework offers a comprehensive approach for optimizing pregnancy mHealth applications and supporting maternal health promotion. CLINICAL TRIAL NUMBER: Not applicable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.