Table 1.

Desirable features of mobile apps supporting behavior change in management of GDM^a, as described by Kytö et al [14].

Feature	Detail
1. Increase competence to manage GDM with automatic feedback and interactive exploration.	This feature highlights the need for feedback on lifestyle and data exploration in the learning process to manage GDM. In apps, women with GDM have so far received feedback from health care professionals [10], and the perception and effectiveness of automated feedback are largely unknown [14]. Lentferink et al [20] showed that praise and suggestions are especially useful behavior change techniques in mobile apps supporting a healthier lifestyle.
2. Increase autonomy by enabling personalization.	The ways to manage GDM are highly individual and significantly vary from person to person [8]. Personalization has a great impact on the perceived effectiveness of telehealth care in women with GDM. However, it has so far been limited to personalization of the app but not to treatment suggestions [14].
3. Provide social support, especially from the partner.	Encouragement by people with close relationships is important for women with GDM [8,21-24]. The partner’s support is seen as especially valuable in effecting a behavioral change in women with GDM, such as increasing exercise [25], but it has not been considered in existing GDM apps [14]. To support the partner’s willingness to use a GDM app, Peyton et al [26] suggested that pregnancy apps should not be too feminine.
4. Support normal pregnancy and debunk myths about GDM.	Women with GDM want reliable information about their disease [21,27], and this information should be in the same app as information about pregnancy [17].
5. Support dual processing as pregnancy is life changing.	Both reflective and habitual processes should be supported in GDM apps. Especially, habits can be considered important with women diagnosed with GDM, as they are generally well motivated to manage GDM but overwhelmed in their daily life [8]. Motivation for maintaining a healthier lifestyle typically decreases after the birth of the baby [17]. Habits could help maintain a healthier lifestyle after the pregnancy also and thus decrease the probability of type 2 diabetes. Between reflective and habitual processes exists contextual fluid reasoning, which is used in creating simple rules between blood glucose levels and lifestyle [28].
6. Integrate the app with normal pregnancy and existing health care services.	In telehealth solutions for GDM management, tight integration between health professionals and women with GDM has been shown to be important [10]. This plays a significant role in the perceived usefulness of the GDM apps [29,30].

^aGDM: gestational diabetes mellitus.