Developing a Guided Web App for Postpartum Depression Symptoms: User-Centered Design Approach (Preprint)

Abstract

BACKGROUND Psychological internet-based interventions have shown promise in reducing perinatal depressive symptoms, but their effectiveness can be hindered by low user engagement. This challenge often arises from a misalignment between technology attributes, user needs, and context. A human-centered, iterative approach involving all stakeholders is recommended. OBJECTIVE To develop a user-friendly internet-based intervention for perinatal women with depressive symptoms. METHODS The development process followed the CeHRes Roadmap phases of contextual inquiry, value specification, and design. It involved a comprehensive literature review, two surveys, ten focus groups, five usability interviews, and a technical pilot. RESULTS The contextual inquiry revealed a demand for accessible interventions for perinatal mental health, with internet-based solutions seen as viable options. Insights from the literature influenced intervention content and features. Stakeholders' openness to the intervention became evident during this phase, along with the integration of the first set of values. The value specification phase further defined the central values and translated them into requirements. In the design phase, feedback was obtained on the user experience of an early digital prototype and on the prototype's final version. The resulting intervention, named "Mamá, te entiendo" ("Mom, I get you"), is a guided web app based on cognitive-behavioral therapy principles, integrating elements from attachment and mentalization theories. It aims to reduce depressive symptoms in women during the first months postpartum and consists of six core sequential modules, along with three additional modules, including five case examples illustrating depressive symptoms and therapeutic techniques. The intervention provides homework exercises and offers users the opportunity to receive feedback from an e-coach through the web app. CONCLUSIONS This study emphasizes the importance of a human-centered and iterative development process for psychological internet-based interventions. This process helps clarify user needs and provides valuable feedback on service design and quality, ultimately having the potential to enhance the utility and, presumably, the effectiveness of the intervention. The discussion section shares valuable insights from the project, such as the value of the requirement sessions.