Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 3, 2024
Date Accepted: Nov 28, 2024
Development and Evaluation of a Mindfulness-Based Mobile Intervention for Perinatal Mental Health: A Randomized Controlled Trial
ABSTRACT
Background:
Perinatal mental health problems such as anxiety, stress and depression warrant particularly close monitoring, intervention, but they are easily overlooked with limited treatment accessibility and resources. Mobile health interventions may be an effective and more accessible mode of treatment for perinatal mental health. Development and evaluation of mobile mental health intervention specific for pregnant women are warranted.
Objective:
A mindfulness-based mobile intervention on perinatal anxiety, depression, and stress was developed. We aimed to investigate the effectiveness of this mobile intervention.
Methods:
Pregnant women were recruited and randomized to an intervention or a wait-list control (WLC) group. The intervention group participated in a self-administered 4-week smartphone-based mindfulness program. Anxiety, depression, and stress were self-assessed as primary outcomes at baseline and post-intervention. Secondary outcomes were mental health well-being, maternal-fetal attachment, and skills of mindfulness. The usability of the mobile intervention was also evaluated.
Results:
A total of 133 pregnant women were randomly assigned to the intervention (n=66) or the control group (n=67). The overall dropout rate was 30% (39/133). The intervention group showed a significant decrease in anxiety compared to the control group after the mindfulness intervention (group x time interaction P = .04). No differences were found for depression and stress between the baseline and post-intervention. For mental health well-being, a significant interaction effect was found between the groups on total scores of well-being and emotional, social, and psychological well-being (group x time interaction P = .01, .01, .03, and .03, respectively). Domains including differentiation self from fetus and attributing characteristics to fetus of maternal-fetal attachment, and awareness of mindfulness also improved in the intervention group compared to the control group (group x time interaction P = .02, .04, and .03, respectively). A significant group effect was found on the awareness of mindfulness and attributing characteristics to fetus of maternal-fetal attachment (P = .01 and .03, respectively). Around 88% (70/80) of participants agreed that the mobile-based mindfulness intervention is feasible based on high usability.
Conclusions:
A mindfulness-based mobile program may be an effective intervention to reduce prenatal anxiety, as well as improving overall mental health well-being and maternal-fetal attachment. Mobile intervention may be a cost-effective and highly feasible method to promote perinatal mental health. Clinical Trial: KCT0007166
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