Earlier this year, Parla, together with the Wellcome Trust and researchers at University College London, undertook a study to understand the impact a digital platform, like Parla, could have on the preconception health of women trying to conceive. The project not only revealed much about the effect that these accessible support networks can have on those trying to conceive, but it was also an integral part of the development of Parla. Last month we shared our findings at an event at The Wellcome Collection and now we are excited to share them with our community.
The Importance of Preconception Health
Good preconception health lays the foundation for a healthy pregnancy and has positive health benefits for both mother and baby. However, despite its importance gaining recognition by healthcare professionals, there is limited support for women and couples during this period. For many women, they only start to interact with fertility experts about elements of preconception health, once they are already experiencing difficulties conceiving. As a digital platform, Parla is aiming to bridge this knowledge gap, and improve access to preconception support for women much earlier in their journey.
There are numerous factors that can impact preconception health
Maternal weight – overweight and obese women have a higher risk of poor birth outcomes as well as a higher risk of their children being overweight or obese.
Folic acid - reduces the risk of neural tube defects, yet only 31% of women take folic acid before pregnancy
Mental health – poor preconception mental health is associated with increased odds of experiencing pregnancy complications.
Long-term physical or mental health conditions – two-thirds of maternal deaths occur in those with pre-existing physical or mental health conditions.
Alcohol - alcohol consumption in pregnancy increases risk of miscarriage, premature births, low birth weight and fetal alcohol spectrum disorder (FASD).
Smoking in pregnancy – causes up to 2,200 premature births, 5,000 miscarriages and 300 perinatal deaths per year.
Age – the risk of birth complications, congenital abnormalities, stillbirth and emergency section increases with age. However, the exact age at which these risks increase is uncertain and co-existence of additional risk factors (e.g. smoking) increases the chance of adverse birth outcomes.
Aside from age, all of these risk factors are avoidable if you take a proactive approach to your preconception health. This is exactly why we created Adia and why the Wellcome Trust funded our research and pilot, recognising the importance of this approach and our mission to enable greater access to proactive reproductive health.
Our Study
There is currently a distinct lack of research into preconception health and how interventions, such as Parla, can have a positive impact on the physical and mental health of women utilising such interventions. We partnered with the Wellcome Trust and UCL for this pilot study, in the hope that we can begin to add to this research and spearhead progress in this area.
For the study, we tracked 400 Parla users over a 90 day period. This was a mixed-method study meaning we interacted with users in numerous ways including email surveys and phone interviews. This allowed us to collect both quantitative and qualitative data about their experience and to gain a holistic view of how our work was affecting their preconception experience. We then related this data to their personal profile and history, such as whether they were already trying to conceive or had already experienced difficulties. The vast majority of those surveyed were actively trying to conceive whilst a few participants were planning on conceiving in the next few years.
The aim of the study was to gain a better understanding of factors including:
How using Parla impacts the user – whether engagement with the platform providing access to expert knowledge and support during the preconception period leads to improved levels of:
- knowledge of fertility health
- perceived support
- perceived stress
Participants undertook surveys at the beginning and the end of the 90 day period so we could see how their levels of knowledge, perceived support and perceived stress changed the more they used Parla. They were asked to mark these three factors out of 7, before and after the pilot.
How users engage with Parla – how often they logged on to the platform, and how long they spent on key areas of the product
Women’s experiences of Parla and suggestions for improvement – We are constantly iterating the product so want to ensure it offers the most impactful information in this most accessible way.
The Results
Impact of Users in the Preconception Period
On average, we saw a positive impact on all the factors we were measuring from our users.
Knowledge of fertility health increased from 4.4 at the start of the pilot to 5.1 after the 90 day period. Perceived support saw an even more dramatic increase, going from a score of 2.9 to 4.3. Perceived stress levels decreased from 4.9 to 3.6 after 90 days – implying Adia was having a beneficial effect on the user’s mental health.
These were encouraging results to see in only 90 days, and we’re confident that the longer people are using Parla, the stronger the positive impact will be.
Experience on the platform
We had some wonderful feedback during the study. All women who took part in the interviews said they would recommend Parla to a friend. Several women reported that the use of Parla had motivated them to make changes to their lifestyle, such as starting to take prenatal vitamins, starting to meditate on a regular basis and starting to make changes to their diet.
Although different aspects of the platform were highlighted as useful by different users, the majority reported that they found the access to fertility experts via messaging – the “Ask The Expert feature”, the meditation programmes, and our the At-Home Fertility Test the most useful. Ask The Expert was the most popular feature, with consistent feedback from women that it was reassuring to know that there was someone available to answer questions and provide trusted information. Many enjoyed that the meditations were created specifically for those trying to conceive and that the test could be done in the privacy of your own home.
Suggestions for Improvements
Getting feedback on how we could make Parla even better was one of the most valuable aspects of the study. Users made insightful suggestions, such as having information tailored to users knowledge levels and creating a feature where users can connect with each other to offer peer support – both of which will influence our product road map in the near future! One of the most common pieces of constructive feedback was that the design could be sleeker. This is something we have already started to incorporate with our latest product release. We have recently launched our brand new look and feel app which is more intuitive and easier to navigate, with many of the features now available in audio.
Always Learning
This study was an invaluable opportunity for us to understand the potential Parla has and to ensure that we are providing the best product for the people that need it the most. Our aim is to become a trusted companion for women at every step of their reproductive health journey, particularly giving much-needed support at the preconception stage. Furthermore, we want to bring an end to this fragmented approach to mental and physical health and bring them together in a unified platform. We are proud of the developments that we have been through since this study was undertaken, and we are excited to keep learning from our community and to keep developing in the future.
