Digital Health Systems in Maternal Mental Health: A Focus Group Assessment of Patient Needs and Views (Preprint)

BACKGROUND Peripartum depression has an incidence rate of approximately 11% among pregnant women and new mothers in the U.S, yet many cases go undiagnosed and untreated due to psychosocial and logistical barriers. The interdisciplinary nature of PPD management presents a challenging scenario for communication and coordination between care providers and patients. Digital technologies offer many opportunities to improve mental healthcare management for women seeking pre- and-postnatal care. They provide a discrete, practical medium that is well-suited for the sensitive nature of mental health. However, current digital interventions in this domain provide suboptimal support and their responsiveness to end user needs is quite limited. OBJECTIVE Our objective is to map the terrain of information needs of women seeking pre-and-postnatal care, specifically for the management of their mental health. Ultimately, we will apply the derived insights to inform our development efforts of a novel digital solution to be used in an academic clinical setting. METHODS This qualitative study consists of semi-structured focus group interviews with a total of nine patients receiving care at an academic Obstetrics and Gynecology clinic. Discussion questions covered topics such as smartphone use and pregnancy apps. A total of two sessions were conducted and audio recorded. Data from the recordings were analyzed through thematic analysis. Overarching themes and views from the sessions were annotated. A survey was also administered to assess participants’ information seeking behavior and use of popular applications. RESULTS Access to smartphones and data plans was not an issue for participants. All used at least one pregnancy app, and three used additional health apps such as pedometers. Easy access to informational and human resources such as evidenced-based pregnancy information, their healthcare providers, and their peers was common across participants. The sense of community offered in discussion boards was also important to participants. Lack of postpartum support and limited personalization of user experience in current digital tools were identified as gaps and barriers for management of PPD and other mental health disorders. Digital technology features recommended by participants were: 1) a journaling feature, 2) online library of keywords linking to credible information, 3) a responsive bi-directional communication pathway to interact with their clinical team, and 4) personalized support for second pregnancy, diabetes, and prior depressive episodes. CONCLUSIONS Users prefer digital technology systems that go beyond a generic approach. They also want these systems to be adaptable to their needs at the moment, whether it is consulting with their provider or simply seeking peer support. Future technologies aimed at maternal mental health should focus on the individual needs of patients, while at the same time offering them common digital tools such as online communities and easy access to reliable information. CLINICALTRIAL N/A