Co-Designing a Mobile Health Application to Support Parents of Preterm Infants from Hospital to Home: A Qualitative Study (Preprint)

BACKGROUND Parents of preterm infants experience the journey from the neonatal intensive care unit (NICU) to home as a dynamic and emotionally demanding trajectory marked by uncertainty, frequent transitions, and evolving parental roles. Mobile health (mHealth) tools may support this transition, but existing solutions often lack context-adapted, evidence-based content grounded in the needs of both families and healthcare professionals. OBJECTIVE This study aimed to explore the experiences and needs of parents of preterm infants and neonatal healthcare professionals, and to examine how these perspectives informed the iterative design of a dedicated mHealth prototype. METHODS The study followed a qualitative crossed-perspectives design in a Swiss tertiary-care NICU. In wave 1, semi-structured interviews and think-aloud sessions were conducted with 18 parents and 17 healthcare professionals using a literature-informed prototype. In wave 2, 10 parents evaluated a revised prototype and discussed early post-discharge needs. Data were analyzed using reflexive thematic analysis and iteratively translated into prototype refinements. RESULTS Parents described the NICU experience as emotionally fragmented, with strong needs for meaningful, coherent information, and continuity across transitions. Professionals acknowledged these needs while highlighting clinical and organizational constraints. Participants valued digital features that reduced cognitive load, centralized trustworthy information, and facilitated communication. Wave 2 confirmed the relevance of the refined features—particularly direct messaging with healthcare professionals, categorized resources, infant tracking, and a shared agenda—for supporting both hospitalization and early home adaptation. CONCLUSIONS These findings suggest that effective digital support for NICU families should reduce cognitive load, provide validated and coherent information, and facilitate communication and guidance across the hospital-to-home transition while avoiding features that may increase anxiety or social comparison.