{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:29:53Z","timestamp":1790461793313,"version":"4.1.0"},"reference-count":47,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n 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. 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to bridge the gap between the World Health Organization (WHO) self-care framework and local practice by designing and piloting the \u201cHealthy Pregnancy\u201d intervention, a multiplatform digital ecosystem for women with GDM in northern Vietnam, through a staged cocreation and pilot refinement process.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between December 2022 and February 2024, drawing on the WHO\u2019s conceptual framework for self-care and cocreation approach, we iteratively developed \u201cHealthy Pregnancy,\u201d a digital health intervention, in 4 stages: (1) formative studies and self-care construct prioritization, (2) cocreation processes with key stakeholders, (3) development and design translation, and (4) pilot testing and final refinement.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In stage 1, we identified gaps in current digital health interventions in low- and middle-income countries, explored the sociocultural realities of women with GDM in Vietnam, and prioritized 7 self-care constructs. In stage 2, we conducted a cocreation workshop to enable key stakeholders to co-design the foundational infrastructure for the potential intervention. In stage 3, we established a multicomponent digital intervention ecosystem with explicitly defined operating workflows. Finally, in stage 4, we gathered suggestions for a digital health intervention from a pilot test group of pregnant women with GDM, to refine and optimize the system schematic and information flow before moving to the real intervention.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n By applying a cocreation approach across all stages of development of the \u201cHealthy Pregnancy\u201d digital health intervention, from problem identification to solution development and evaluation, we developed a locally tailored GDM self-care model. This process not only addressed gaps in standard care but also empowered pregnant women through a supportive, multiple-stakeholder environment. This study demonstrates a rigorous cocreation pathway for systematically translating WHO self-care constructs into a feasible, culturally adapted digital ecosystem for GDM in Vietnam and offers a transferable, people-centered design process alongside a practical blueprint for integration into routine maternal care.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/82434","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T15:00:08Z","timestamp":1775228408000},"page":"e82434-e82434","source":"Crossref","is-referenced-by-count":1,"title":["Digital Health\u2013Based Peer Support Ecosystem for Gestational Diabetes Mellitus in Vietnam (VALID II Study): Multistakeholder Cocreation and Pilot Study"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9035-4861","authenticated-orcid":false,"given":"Ngoc Anh Thi","family":"Dang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1108-8987","authenticated-orcid":false,"given":"Dan W","family":"Meyrowitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0851-6760","authenticated-orcid":false,"given":"Ditte S","family":"Linde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5084-6053","authenticated-orcid":false,"given":"Christina A","family":"Vinter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3867-6597","authenticated-orcid":false,"given":"Thanh Duc","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0351-2672","authenticated-orcid":false,"given":"Dang Kien","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4389-5225","authenticated-orcid":false,"given":"Thi Ai","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0061-0592","authenticated-orcid":false,"given":"Hieu Minh","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6577-3464","authenticated-orcid":false,"given":"Thi Kim Dung","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0138-7803","authenticated-orcid":false,"given":"Thi Huong","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-2370","authenticated-orcid":false,"given":"Tine M","family":"Gammeltoft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1629-1864","authenticated-orcid":false,"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by international association of diabetes in pregnancy study group\u2019s criteria","volume":"183","author":"Wang","journal-title":"Diabetes Res Clin Pract"},{"issue":"1 Suppl 1","key":"R2","doi-asserted-by":"publisher","first-page":"S306","DOI":"10.2337\/dc25-S015","article-title":"15. 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