Evaluation of the uptake and usability of the pregnant women surveillance system ( SIMG ): A cross‐sectional pilot study

Key findings from this study

This research indicates that:

• SIMG achieved marginal usability with a mean System Usability Scale score of 67.5, with only 40.7% of users scoring in the acceptable range.
• Actual uptake and repeated use of the platform were suboptimal at 47.1% and 52.9% respectively, despite 88% of participants indicating willingness to use it in future pregnancies.
• Participant characteristics including age, marital status, family income, and geographic region showed no significant association with System Usability Scale scores.
• Limited time availability, inadequate internet access, technological illiteracy, and complicated implementation procedures were primary barriers to platform adoption and sustained engagement.

Overview

This cross-sectional pilot study evaluated uptake and usability of SIMG, a web-based telehealth application for integrated pregnancy monitoring developed by the Brazilian Network for Studies on COVID-19 in Obstetrics. The tool employs decision trees and risk calculators for surveillance and clinical decision support during pregnancy and postpartum periods, accessible via mobile devices or browsers.

Methods and approach

Researchers contacted 111 participants from the REBRACO cohort who had used SIMG between October and November 2022. Participants completed the System Usability Scale questionnaire online and participated in telephone interviews. Descriptive analysis examined sociodemographic and obstetric variables. Univariate and multivariate linear regression analyses identified factors associated with platform uptake and usability. Uptake was defined as successful registration and at least one login during the study period.

Results

Among 111 invited participants, 54 (48.7%) completed the assessment. The mean age was 31 ± 6.9 years, with 65% aged 18-35 years, predominantly residing in southeastern Brazil with partners. SIMG demonstrated marginal usability with a mean System Usability Scale score of 67.5 ± 19.8. Only 40.7% of participants scored above 70, indicating acceptable usability. Tool uptake was suboptimal at 47.1%, with only 52.9% using it more than once, reflecting significant adherence challenges. Regression analysis revealed no significant differences in usability scores based on participant characteristics.

Despite suboptimal engagement metrics, 88% of respondents expressed willingness to use SIMG in future pregnancies. Limited time availability, inadequate internet access, technological illiteracy, and complicated implementation procedures contributed to low acceptance. Literature indicates that pregnant women's engagement with digital self-monitoring tools often declines despite initial interest in digital health resources for information access.

Implications

The findings demonstrate that successful telehealth implementation for prenatal care requires addressing barriers beyond technical functionality. Investment in user-centered design that prioritizes seamless clinical integration over burdensome protocols is necessary to improve engagement. SIMG shows potential for facilitating early detection of warning signs and extending healthcare reach to underserved populations, but realizing this potential depends on enhancing usability and user confidence.

The study underscores that telehealth strategies must account for structural inequalities in maternal health access. Technical issues, complicated workflows, and psychological barriers to active self-monitoring require systematic remediation. Future digital maternal health interventions should prioritize accessibility for populations with limited technological literacy and inconsistent internet connectivity.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.