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      Perceptions Toward the Use of Digital Technology for Enhancing Family Planning Services: Focus Group Discussion With Beneficiaries and Key Informative Interview With Midwives

      research-article
      , MSCP, CBT, IPT 1 , , , RN, PhD 2 , , MSc, MD, PhD 1 , , BDS, MSc, MSPH, MHPE, ScD 3 , , PhD 4 , , MA, PhD 4 , , PhD 5 , , PhD 1 , , MPH, MD 1
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      family planning, mobile apps, social media, digital technology, contraceptives

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          Abstract

          Background

          Modern family planning (FP) methods allow married couples to discuss and determine the number of children and years of spacing between them. Despite many significant improvements in FP services in Jordan, there are still many issues related to the uptake of FP services for both host communities and Syrian refugees, due to limitations in the health care system based on public health facilities. Digital technologies can provide opportunities to address the challenges faced in the health system, thus offering the potential to improve both coverage and quality of FP services and practices.

          Objective

          The aim of this study was to explore the perceptions of Jordanian women, Syrian refugees, and midwives in Jordan toward the use of digital health technology to support and enhance access to FP services.

          Methods

          We employed a qualitative study based on semistructured, face-to face key informative interviews with 17 midwives (providers) and focus group discussions with 32 married women of reproductive age (clients). Both midwives and clients were recruited from 9 health centers in 2 major governorates in Jordan (Irbid and Mafraq), where 17 in-depth interviews were conducted with midwives and 4 focus groups were conducted with the women. Each focus group included 4 Syrian refugees and 4 Jordanian women. The transcribed narratives were analyzed using inductive thematic analysis.

          Results

          Three major themes were derived from the narratives analysis, which covered the pros of using digital technology, concerns about digital technology use, and the ideal app or website characteristics. Ten subthemes emerged from these 3 main themes. Overall, midwives and women (Syrian refugees and host communities) agreed that digital technology can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman’s awareness and knowledge regarding the FP methods and their side effect. Furthermore, digital technology can assist in enabling women’s empowerment, which will allow them to make better decisions regarding FP use. No harmful risks or consequences were perceived to be associated with using digital technology. However, several concerns regarding digital technology use were related to eHealth literacy and the accuracy of the information provided. Midwives were mainly concerned about the patients who would rely mostly on the technology and choose to avoid consulting a health care professional.

          Conclusions

          As perceived by midwives and women, incorporating digital technology in FP services can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman’s awareness regarding the FP methods and their side effect. It may also empower the women to play an active role in the shared (with their husband and family) decision-making process. Therefore, digital technologies are recommended to address the challenges faced in health system and to improve both the coverage and the quality of FP services and practices.

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          Most cited references39

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          Using thematic analysis in psychology

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            eHealth Literacy: Essential Skills for Consumer Health in a Networked World

            Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.
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              Thematic analysis

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                July 2021
                28 July 2021
                : 23
                : 7
                : e25947
                Affiliations
                [1 ] Global Health Development | Eastern Mediterranean Public Health Network Amman Jordan
                [2 ] Department of Allied Medical Sciences Faculty of Applied Medical Sciences Jordan University of Science and Technology Irbid Jordan
                [3 ] Department of Community Medicine, Public Health and Family Medicine Faculty of Medicine Jordan University of Science & Technology Irbid Jordan
                [4 ] Department of Health Promotion & Community Health American University of Beirut Beirut Lebanon
                [5 ] Department of Health Management and Policy Jordan University of Science and Technology Irbid Jordan
                Author notes
                Corresponding Author: Hind Yousef hyousif@ 123456globalhealthdev.org
                Author information
                https://orcid.org/0000-0002-3533-1032
                https://orcid.org/0000-0002-6106-1099
                https://orcid.org/0000-0003-1212-1611
                https://orcid.org/0000-0002-7830-6857
                https://orcid.org/0000-0003-4200-3130
                https://orcid.org/0000-0002-0707-7196
                https://orcid.org/0000-0003-2345-4892
                https://orcid.org/0000-0001-8710-8249
                https://orcid.org/0000-0002-5842-6739
                Article
                v23i7e25947
                10.2196/25947
                8367154
                34319250
                93757f57-6549-4bcb-aabc-78d592337ff1
                ©Hind Yousef, Nihaya Al-Sheyab, Mohannad Al Nsour, Yousef Khader, Malika Al Kattan, Marco Bardus, Mohammad Alyahya, Hana Taha, Mirwais Amiri. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.07.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 22 November 2020
                : 29 December 2020
                : 8 January 2021
                : 24 May 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                family planning,mobile apps,social media,digital technology,contraceptives
                Medicine
                family planning, mobile apps, social media, digital technology, contraceptives

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