Bridging Stress and Glycemic Control: User-centered Design and Evaluation of a Holistic mHealth App for Gestational Diabetes Self-management

Gestational diabetes mellitus (GDM) presents significant psychological and physical challenges, and stress is known to adversely affect glycemic control. Despite mindfulness-based interventions (MBIs) showing potential benefits, integrated digital tools that pair stress management with comprehensive GDM self-management remain limited. This study adopted a user-centered, formative usability evaluation approach to refine a mindfulness-based mHealth prototype for individuals with GDM. Building on earlier focus groups that identified user requirements, an interactive, high-fidelity prototype was designed using HTML and JSON to support realistic interactions without backend implementation. Multiple design alternatives were created for key interfaces and evaluated through two usability evaluation workshops involving individuals with GDM (n = 5) and healthcare professionals (HCPs) (n = 5). Data were analyzed using reflexive thematic analysis. Findings revealed strong participants’ endorsement of an integrated, single-dashboard design, with key themes emphasizing holistic integration of psychological and physiological support, reduced cognitive load through simplified navigation and optional tracking, and trust in personalized, clinically aligned educational content. Iterative refinement resulted in a streamlined interactive prototype supporting flexible engagement, clear visualization, and emotionally supportive design. These findings demonstrate the value of user-centered usability evaluation methods in developing acceptable and clinically aligned digital interventions for holistic GDM care.