A co-created digital health intervention to enhance self-care capacities among women with gestational diabetes mellitus in Vietnam (VALID II project). (Preprint)

BACKGROUND Gestational diabetes mellitus (GDM) is associated with fetal overgrowth, increased risks of perinatal morbidity and mortality, and long-term complications for mother and child, including cardiovascular disease and type 2 diabetes (T2D). Innovative peer-based digital health interventions are emerging globally as a potential approach to assist and empower women in effective self-care and well-being during pregnancy. However, there remains substantial potential to develop and evaluate culturally sensitive digital health interventions for pregnant women with GDM, especially in low- and middle-income countries. OBJECTIVE This study aimed to describe the co-creation and development of a culturally appropriate digital health intervention to enhance peer support and self-care capacities among women with GDM in northern Vietnam. METHODS From December 2022 to February 2024, drawing on the WHO’s conceptual framework for self-care and co-creation approach, we iteratively developed the “Healthy Pregnancy” intervention – a digital health intervention in four stages: 1) Scoping review, ethnographic study, and brainstorming; 2) Co-creation workshop with the target population and healthcare professionals (HCPs) regarding intervention content; 3) Design and development; and 4) Pilot testing. RESULTS Within stage 1, we identified the key potential components of a digital health intervention, including the target digital platforms, a new set of visual educational materials, and the essential presence of family engagement and peer support. In stage 2, a co-creation workshop enabled participants and researchers to jointly refine and align identified needs with potential solutions. In stage 3, a structured and visualized set of educational materials, including eight leaflets and videos, was developed and underwent expert review and revision rounds. Finally, at stage 4, suggestions for digital health intervention from a pilot-test group of pregnant women with GDM were gathered to refine and optimize the educational materials and intervention modalities before moving into the real intervention. CONCLUSIONS By integrating a co-creation approach throughout the "Healthy Pregnancy" digital health intervention development process, from identifying problems to developing and evaluating solutions, we constructed a locally and culturally tailored GDM self-care model. With this intervention, not only were the gaps in standard care bridged, but pregnant women with GDM were empowered and accompanied by a supportive multiple-stakeholder environment. CLINICALTRIAL NCT05744856 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s40814-025-01657-x