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. 2023 May 15:25:e39854.
doi: 10.2196/39854.

Using Digital Tools to Study the Health of Adults Born Preterm at a Large Scale: e-Cohort Pilot Study

Elsa Lorthe  1   2 , Carolina Santos  1   2 , José Pedro Ornelas  3 , Julia Nadine Doetsch  1   2 , Sandra C S Marques  1   4 , Raquel Teixeira  1   2 , Ana Cristina Santos  1   2   5 , Carina Rodrigues  1   2 , Gonçalo Gonçalves  3 , Pedro Ferreira Sousa  3 , João Correia Lopes  3   6 , Artur Rocha  3 , Henrique Barros  1   2   5
Affiliations

Using Digital Tools to Study the Health of Adults Born Preterm at a Large Scale: e-Cohort Pilot Study

Elsa Lorthe et al. J Med Internet Res. .

Abstract

Background: Preterm birth is a global health concern. Its adverse consequences may persist throughout the life course, exerting a potentially heavy burden on families, health systems, and societies. In high-income countries, the first children who benefited from improved care are now adults entering middle age. However, there is a clear gap in the knowledge regarding the long-term outcomes of individuals born preterm.

Objective: This study aimed to assess the feasibility of recruiting and following up an e-cohort of adults born preterm worldwide and provide estimations of participation, characteristics of participants, the acceptability of questions, and the quality of data collected.

Methods: We implemented a prospective, open, observational, and international e-cohort pilot study (Health of Adult People Born Preterm-an e-Cohort Pilot Study [HAPP-e]). Inclusion criteria were being an adult (aged ≥18 years), born preterm (<37 weeks of gestation), having internet access and an email address, and understanding at least 1 of the available languages. A large, multifaceted, and multilingual communication strategy was established. Between December 2019 and June 2021, inclusion and repeated data collection were performed using a secured web platform. We provided descriptive statistics regarding participation in the e-cohort, namely, the number of persons who registered on the platform, signed the consent form, initiated and completed the baseline questionnaire, and initiated and completed the follow-up questionnaire. We also described the main characteristics of the HAPP-e participants and provided an assessment of the quality of the data and the acceptability of sensitive questions.

Results: As of December 31, 2020, a total of 1004 persons had registered on the platform, leading to 527 accounts with a confirmed email and 333 signed consent forms. A total of 333 participants initiated the baseline questionnaire. All participants were invited to follow-up, and 35.7% (119/333) consented to participate, of whom 97.5% (116/119) initiated the follow-up questionnaire. Completion rates were very high both at baseline (296/333, 88.9%) and at follow-up (112/116, 96.6%). This sample of adults born preterm in 34 countries covered a wide range of sociodemographic and health characteristics. The gestational age at birth ranged from 23+6 to 36+6 weeks (median 32, IQR 29-35 weeks). Only 2.1% (7/333) of the participants had previously participated in a cohort of individuals born preterm. Women (252/333, 75.7%) and highly educated participants (235/327, 71.9%) were also overrepresented. Good quality data were collected thanks to validation controls implemented on the web platform. The acceptability of potentially sensitive questions was excellent, as very few participants chose the "I prefer not to say" option when available.

Conclusions: Although we identified room for improvement in specific procedures, this pilot study confirmed the great potential for recruiting a large and diverse sample of adults born preterm worldwide, thereby advancing research on adults born preterm.

Keywords: RECAP Preterm; Research on European Children and Adults born Preterm; citizen science; cohort study; e-cohort; epidemiology; global burden; global health; health outcome; life course epidemiology; mobile phone; observational study; participant involvement; premature; prematurity; preterm; preterm birth; questionnaire; survey.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Overview of multifaceted communication strategy. ASPHER: Association of Schools of Public Health in the European Region; EFCNI: European Foundation for the Care of Newborn Infants; ES: España (Spain); FR: France; HAPP-e: Health of Adult People Born Preterm—an e-Cohort Pilot Study; ISPUP: Institute of Public Health of the University of Porto; IT: Italy; PT: Portugal; UP: University of Porto.
Figure 2
Figure 2
Flowchart of participants enrolled in the Health of Adult People Born Preterm—an e-Cohort Pilot Study.
Figure 3
Figure 3
Country of birth of participants enrolled in the Health of Adult People Born Preterm—an e-Cohort Pilot Study. The colors correspond to the number of participants per country.
See this image and copyright information in PMC

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