Grant: CIHR Fellowship

This program of research will produce practical tools for evaluating the readiness for sustainable integration of a mobile health intervention, the PIERS app, in a low-resourced health system setting. The PIERS app is a decision aid for clinical management of women with hypertensive disorders of pregnancy. This app is currently being evaluated in a cluster randomized controlled trial to determine impact of its use on maternal and perinatal mortality and major morbidity. It is critical that we establish effectiveness of the app but this information does not guarantee that its use can be sustained after the trial ends. What is needed is a broader understanding of end-user and health system requirements for sustainable integration in the health systems where we are completing the clinical trial. At the end of this fellowship I will be able to demonstrate who, where and what are required for sustainable integration of the PIERS app in the low-resourced health systems where the CLIP trial is being completed. The who refers to understanding the health system human resource and stakeholder partners required for technology adoption; the where refers to understanding the place within the health system where this tool will have the greatest chance of success (ie> community or facility health setting); and the what refers to the technology and health system infrastructure requirements needed to maintain use. During this fellowship I will gain valuable skills in qualitative methodologies and partnership development that are critical to achieve my career goal of leading a successful global health informatics research program, focused on mHealth app integration in complex health systems. This fellowship work will build on a significant foundation of success in development and piloting of mobile health interventions gained during my graduate training to bridge the gap from research to sustainable integration.