P0337 - Mother’s Milk Messaging™ (MMM): Mothers Favor Daily Texting and Reliability of App Content in Qualitative Evaluation

Background: Although the benefits and advantages of breastfeeding (BF) are known, disparities exist in BF practices from different ethnic/racial groups. We developed and evaluated an app (MMM) in English and Spanish to help mothers from late trimester through 2 months postpartum meet their BF goals. MMM includes theoretical-based text messaging with social support features, videos and evidence-based written content to encourage BF exclusivity and duration among first time mothers.

Objective: To understand the perspectives of first-time mothers using an evidence-based BF app.
Design/

Methods: We conducted 60 focused telephone interviews with a subgroup from a total of 311 participants completing a randomized controlled trial of the breastfeeding app. We aimed questions at obtaining reactions to the app content, understanding engagement and how the app influenced their BF experience. We also explored other influences (providers, family, friends) on BF for these mothers. We content coded the transcripts of focused interviews and analyzed for thematic domains using Atlas Ti and then performed comparisons for concurrence and differences. Two of the four domains ‘Use of app’ and ‘BF experience/journey’ are presented here.

Results: Demographics included mothers with mean age 29, 23% Hispanic, 80% White, 68% married and 90% with some post high school education. These subgroup mothers were similar to the larger trial population. Participants who accessed and engaged with the app had positive attitudes towards the usefulness of the app during their BF journey. Most participants preferred receiving the app’s BF text messages as well as the texts with bidirectional quizzes. Mothers also appreciated the reliability of the information on the app. Engagement of the app varied by each individual’s BF experiences. We learned that discontinuation of app use was common among mothers reporting early problems and also no problems with BF. Most mothers engaged in the app once the baby was born. Illustrative quotes as shown in Table1.
Conclusion(s): White, married, and highly educated mothers were the highest utilizers of the new MMM app despite a bilingual and culturally enhanced option. Daily texts were favored most, and perceptions of content and structure were positive. This information provides perspectives to assist in improving engagement and plans for dissemination for mothers in the middle ground where this app may be most useful.