Responding to women's needs and preferences in an online program to prevent postpartum depression

Abstract

PurposeGlobal access to adequate resources to address postpartum depression (PPD) are limited and, at times, not reflective of the needs of pregnant women and new mothers. Gathering information about the preferences and needs of women when designing and implementing Internet-based programs is warranted, especially given the diversity of experiences related to childbirth. Thus, the aim of this study was to obtain user feedback on the content, structural, and cultural factors associated with a fully automated online PPD prevention intervention that, like similar programs, suffered from poor adherence and engagement.MethodsFollowing the completion of the Mothers and Babies Internet Course (eMB), an online prevention of PPD trial, a convenience sampling method was used to invite consenting participants to return to the site. Participants provided anonymous feedback on how to improve and adapt the eMB based on screenshots and video content from the Internet intervention. Demographic information and engagement in the online trial were examined as factors influencing participant responses.ResultsOne hundred nineteen English and Spanish speaking women from 27 countries and territories provided feedback about the eMB. Content-based feedback included requesting additional detail in explanations and simplifying recommended exercises. Structure-based feedback included requests for more visual representations of the materials. In general, participants did not explicitly suggest culturally specific feedback that differed by geographic region, but instead reported similar themes related to motherhood and childrearing. An unexpected finding that only emerged among English-speaking participants was the need for the eMB to address perfectionism and introspection as factors that impact motherhood. Relative to those who did not access the eMB in the parent study, women who did thought the intervention content was acceptable (i.e., no suggested changes) and provided feedback that referenced maternal stress and pregnancy experiences. Age, education, pregnancy status and number of children were not significant factors associated with participants' use of the eMB.ConclusionsFindings from this study offer preliminary information about the needs and preferences of an international sample of childrearing women who access automated Internet interventions to manage mood changes during the perinatal period.

A Social Media Group Cognitive Behavioral Therapy Intervention to Prevent Depression in Perinatal Youth: Stakeholder Interviews and Intervention Design

“…Barrera et al [ 29 ] adapted the program as a self-guided individual internet program that included videos, written materials, and visual summaries. Consistent with our findings, the intervention of Barrera et al [ 45 ] recommended simplification of content, detailed instructions, and graphical representations. Sawyer et al [ 30 , 31 ] also used the MB content as part of a mobile app.…”

Effectiveness of online psychological and psychoeducational interventions to prevent depression: Systematic review and meta-analysis of randomized controlled trials

“…), and participation can be completed at any individual speed. Nowadays one limitation of online depression prevention interventions is poor adherence as this can contribute to reduce their effectiveness (Calear, Christensen, Mackinnon, Kathleen, & Griffiths, 2013;Kelders, Bohlmeijer, & Van Gemert-Pijnen, 2013;Ramphos, Kelman, Stanley, & Barrera, 2019). In our meta-analysis, we found that more interactive online interventions were more effective than more passive ones (Morgan et al, 2012), even if they were delivered with attractive messages and videos (Whittaker et al, 2017).…”

Digital mental health for postpartum women: perils, pitfalls, and promise

“…This may include solutions for access to technology, resources for digital literacy, or other changes that help historically disenfranchised women feel safe using these tools. The Mothers and Babies Internet Course is a great example of how to do this well; the authors built an internet-based PPD prevention intervention based on evidence-based modalities, and then surveyed a diverse group of mothers about how the intervention could be improved to better reflect the needs of women from diverse backgrounds 35 .…”