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Abstract
Despite decades of healthcare initiatives, Malaysia’s maternal mortality ratio has plateaued at concerning levels, partly due to underutilized pre-pregnancy care (PPC) services. This study aims to develop, validate, and evaluate a PPC checklist mobile health (mHealth) app for Malaysian women. Using a three-phase, human-centered design (HCD), phase 1 employs a qualitative study to develop a culturally adapted PPC checklist through nominal group techniques with women (n = 8) and experts (n = 9), followed by content validation (n = 7). Phase 2 creates a prototype based on self-determination theory (SDT) and the Wheel of Sukr, integrating gamification features, and conducting face validation with users (n = 10). Phase 3 employs a cross-sectional survey to evaluate usability through the validated Malay version of the mHealth app usability questionnaire with 117 female outpatients across government clinics in Selangor. The HCD approach guides iterative development through continuous user feedback, ensuring contextual relevance, while SDT informs the design of gamification features by supporting autonomy, competence, and relatedness. Expected outcomes include a culturally validated PPC checklist prototype with good usability. This study offers a novel, theory-driven digital tool to enhance PPC service engagement and utilization in Malaysia and other similar healthcare settings.
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Type: Study Protocol
ELECTRON J GEN MED, Volume 22, Issue 5, October 2025, Article No: em674
https://doi.org/10.29333/ejgm/16620
Publication date: 01 Sep 2025
Online publication date: 16 Jul 2025
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