{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T08:53:08Z","timestamp":1774083188244,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000877","name":"Rockefeller Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to investigate factors influencing the acceptance of smartphone applications among high\u2010risk pregnant women in the Lao People's Democratic Republic to support continuous care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An explanatory sequential mixed\u2010methods design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The quantitative phase included 167 high\u2010risk pregnant women recruited from four tertiary hospitals in Vientiane, Lao PDR. Validated questionnaires were used to measure demographics, digital technology usage, eHealth literacy and anxiety. Data were analysed using descriptive statistics and multiple regression analysis. In the qualitative phase, in\u2010depth interviews with 20 women were conducted to further explore experiences, perceptions and barriers related to smartphone application usage. Interviews were analysed via direct content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Quantitative findings indicated that smartphone application acceptance was significantly predicted by eHealth literacy (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20091.53, 95% CI 1.22\u20131.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and pre\u2010existing non\u2010communicable diseases (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20094.39, 95% CI 1.05\u20137.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010). Anxiety negatively impacted acceptance (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u2009\u22120.28, 95% CI \u22120.51 to \u22120.05,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). The model explained 53.9% of the variance in smartphone application acceptance (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.539). Qualitative findings highlighted four key themes: awareness of pregnancy risks, unclear health information, perceived benefits of smartphone applications including accessibility and emotional reassurance and practical barriers such as internet costs and limited digital literacy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Positive perceptions of smartphone applications regarding accessibility and reassurance were observed, alongside significant barriers, such as limited digital literacy and internet costs. Addressing these factors may enhance the adoption and effective utilisation of digital health technologies among high\u2010risk pregnant populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.70010","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T04:54:48Z","timestamp":1753246488000},"page":"3663-3677","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unlocking the Adoption of a Smartphone Application for High\u2010Risk Pregnant Women in the Lao People's Democratic Republic: A Mixed\u2010Methods Study"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-8954","authenticated-orcid":false,"given":"Sasitara","family":"Nuampa","sequence":"first","affiliation":[{"name":"Department of Obstetric and Gynaecological Nursing, Faculty of Nursing Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudaporn","family":"Payakkaraung","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nursing, Faculty of Nursing Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manassawee","family":"Srimoragot","sequence":"additional","affiliation":[{"name":"Department of Obstetric and Gynaecological Nursing, Faculty of Nursing Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lamngeun","family":"Silavong","sequence":"additional","affiliation":[{"name":"Department of Nursing Mahosot Hospital  Vientiane Prefecture Lao People's Democratic Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Metpapha","family":"Sudphet","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecological Nursing Division, Department of Nursing Siriraj Hospital, Faculty of Medicine Siriraj Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soukdavone","family":"Souksavath","sequence":"additional","affiliation":[{"name":"Department of Nursing Mahosot Hospital  Vientiane Prefecture Lao People's Democratic Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"The Impact of e\u2010Health Literacy on the Acceptance of Digital Health Solutions Among Pregnant Women: A Systematic Review","author":"Ahmadian L.","year":"2023"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.702"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.2196\/38082"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104780"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010020\u201003073\u20109"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.015"},{"key":"e_1_2_14_8_1","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell J. 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