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Digital screening for postnatal depression in fathers and non-gestational parents: a mixed methods feasibility study.
ABSTRACT
Background:
Despite its prevalence (9%) in fathers, there is no routine screening for postnatal depression (PND) in fathers and non-gestational parents.
Objective:
Therefore, the current study aimed to test the feasibility, acceptability, validity and safety of a smartphone app to screen for PND in this group.
Methods:
In this single-arm, mixed-methods cohort study fathers and non-gestational parents whose partners were ≥36 weeks pregnant were recruited from National Health Service (NHS) antenatal services. Participants completed baseline assessments exploring demographics, depression, anxiety and quality of life. Participants were then asked to use the CareLoop PND app daily to screen for depression until eight weeks postpartum. Follow-up assessments at eight weeks postpartum explored app acceptability, health service use, quality of life, depression, anxiety, suicidality and postpartum bonding. All participants were invited for an interview to explore app and study feasibility and acceptability. Data were analysed using framework analysis.
Results:
Of the 12 participants recruited at baseline, one was withdrawn, while the remaining used the app until eight weeks postpartum. Ten completed the eight-week follow-up questionnaires, and nine took part in the qualitative interview. A priori “accept” criteria of overall completion rate of app assessments was met; 49% of daily app-based Edinburgh Postnatal Depression Scale (EPDS) assessments were completed, with 64% of participants completing more than half of daily EPDS. Frequency of app use declined over the 12-week app use period; participant characteristics (demographics or method of study referral) did not predict app use over time. The app positively screened one participant for postnatal depression who was referred to their GP and subsequently referred by the GP for psychological intervention. Interview and questionnaire data indicated most participants found the app acceptable to use, although some suggested improvements.
Conclusions:
The findings indicated it was feasible and acceptable for fathers and non-gestational parents to utilise an app for PND screening. Qualitative findings highlighted the importance of overcoming negative societal views of fathers and non-gestational parents with PND, acknowledging their valuable role throughout the perinatal period, and ensuring appropriate mental health support is available. Recommendations are made to refine the app for utilisation with fathers and non-gestational parents.
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Copyright
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