Digital Behavioral Activation Interventions During the Perinatal Period: Scoping Review (Preprint)

Abstract

BACKGROUND Pregnancy is a complex period implying many bio-psycho-social changes and the way women adapt to these changes impacts on their well-being and on the chances of developing mental health problems. Women, during the perinatal period, have expressed a preference for support delivered online. In this regard interventions such as Behavioral Activation (BA), which are brief and structured psychosocial interventions, seem parituclarly suited to be delivered through digital solutions. OBJECTIVE Accordingly, this scoping review intended to map the literature investigating digital BA interventions deployed during the perinatal period. Particular attention was posed on the studies’ methodological underpinning, the potential impact of BA interventions on symptoms other than depression, and the existence of differences occurring when these interventions were administered during pregnancy vs. the postpartum period. METHODS A systematic search compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews (PRISMA-ScR) guidelines was conducted considering five bibliographic databases; reference lists and key journals were also screened by two independent authors following a double-blind apporach. RESULTS A total of 7 studies, published between 2013 and 2022, were included. Two studies were protocols for randomized controlled trials, five were empirical studies and one was a qualitative study. All studies focused on the postpartum period, except one which focused on the broader perinatal period. Promising effects on depression symptoms were reported, yet not on other psychosocial symptoms. Low intervention adherence has emerged, while the usability associated with the digital means used to deploy interventions was scarcely addressed; moreover, information on the digital platforms used was poorly reported overall. CONCLUSIONS Taken together, findings were useful in highlighting the scarcity and preliminary nature of digital BA interventions deployed during the perinatal period, whereby the focus seems more on treatment than prevention. Moreover, future studies should also consider and address usability and user engagement, given their relevance to interventions' efficacy.