Mamma Mia: A Feasibility Study of a Web-Based Intervention to Reduce the Risk of Postpartum Depression and Enhance Subjective Well-Being

Abstract

BackgroundCurrently, 10-15% of women giving birth suffer from symptoms of postpartum depression. Due to a lack of knowledge of this condition and the stigma associated with it, as well as few treatment options, a large proportion of postpartum women with depression remain untreated. Internet-based interventions have been found effective in treating depression, anxiety, phobias, and addictions. Hence, we developed such program (“Mamma Mia”) with the aim of reducing the risk for postpartum depression and enhance subjective well-being. Mamma Mia is based on positive psychology, metacognitive therapy, and couples therapy. It starts in gestational week 22, and lasts until 6 months after birth. During pregnancy, Mamma Mia is delivered weekly (every Monday). After birth, Mamma Mia is delivered three times per week for six weeks. The remaining weeks, the program is delivered more sporadically. In total, Mamma Mia consists of 44 sessions. The program is individualized, interactive, and tunneled (ie, the user is guided through the program in a pre-determined manner).ObjectiveThe purpose of the present study was to pilot test the intervention in order to assess the feasibility and acceptance among program users.MethodsThe present paper reports a feasibility study that combined quantitative survey data with semi-structured interviews. Participants (N=103) were recruited via hospitals, well-baby clinics, and Facebook. Due to time constraint in completing the current study, our results were based on participation in one of the two phases: pregnancy or maternity. Participants in the pregnancy phase were surveyed 4 and 8 weeks after intervention enrollment, and participants in the postnatal phase were surveyed 2 and 4 weeks after intervention enrollment. The survey assessed perceived usefulness, ease-of-use, credibility, and unobtrusiveness. All measures were filled in by participants at both measurement occasions. Data were analyzed by running descriptives and frequencies with corresponding percentages. Binomial tests were carried out to investigate whether demographics differed significantly from a 50/50 distribution. Paired sample t tests were used to examine differences between time 1 and 2. Four participants were interviewed in the qualitative follow-up study, where they were given the opportunity to address and elaborate on similar aspects as assessed in the survey.ResultsMore than two-thirds of users found Mamma Mia to be of high quality and would recommend Mamma Mia to others. By far, most also found the amount of information and frequency of the intervention schedule to be appropriate. Mamma Mia was perceived as a user-friendly and credible intervention.ConclusionsOverall, the user acceptance of Mamma Mia was good and our findings add to the feasibility of the program. The effect of Mamma Mia on depression and subjective well-being will be evaluated in a large randomized controlled trial, and if found to be effective, Mamma Mia could serve as a low-threshold prevention program.

Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial

“…Low adherence and engagement are significant issues commonly discussed within the context of Internet interventions (Eysenbach, 2005) and are problematic even among highly motivated individuals. The rate of engagement with the intervention site in this study (1/8 sessions or 12.5%) was consistent with the average number of sessions completed by pregnant participants in the Haga et al (2013) prevention study (7/44 sessions or 15.9%). Regardless, postpartum women are busy.…”

“…To date, fewer Internet interventions have focused their attention on the prevention of PPD. Haga, Drozd, Brendryen, and Slinning (2013) described a feasibility and acceptance pilot study of an automated, unguided Internet intervention ( Mamma Mia ) to prevent PPD and to enhance well-being among perinatal women. Of the 103 pregnant and postpartum women recruited, 81 engaged with the 44-session intervention.…”

Are Pregnant and Postpartum Women Interested in Health-Related Apps? Implications for the Prevention of Perinatal Depression

“…18 ICTs for the prevention and treatment of perinatal depression are already being used with the majority focused on the development of web pages. 19,20 Current studies have not used apps, which our data suggest is a lost opportunity to address the prevention of perinatal depression.…”

Health professionals' perspective on the promotion of e-mental health apps in the context of maternal depression

“…Extant studies revealed the (potential) value of e-mental health applications for the treatment as well as the assessment and diagnosis both in the context of other mental health conditions [68–71] and related to maternal depression [21]. …”