JMIR Publications

ABSTRACT

Background:

Approximately 15% of pregnant women in the United States develop postpartum depression (PPD). Mothers and Babies (MB) is an in-person cognitive behavioral therapy (CBT)-based curriculum that effectively prevents PPD in low-income perinatal women. Because smartphone application (app)-provided CBT can reduce PPD symptoms and expand the reach of CBT programs, we utilized individual in-depth interviews with low-income perinatal women to develop a novel app, MBapp, that adapts MB to a digital format for this population. During the interviews that guided app development, study participants noted that MBapp would be useful for their partner or would benefit their relationship with their partner.

Objective:

To explore MBapp’s potential utility as a dyadic intervention, we conducted a qualitative analysis of emergent data obtained during the interviews that guided MB’s adaptation to MBapp.

Methods:

English- or Spanish-speaking women with federal health insurance (i.e., a proxy for being low-income) who were between 32 weeks’ gestation and 6 months postpartum were eligible. Consenting participants completed a semi-structured interview. The interview agenda was not designed to elicit discussions on partners; therefore, partner data were emergent. Each interview was recorded, transcribed, and coded by two authors for consensus. Coded data were inputted into NVivo and analyzed. This study was approved by Women & Infant’s Hospital of Rhode Island’s IRB (#1737296).

Results:

25 interviews were completed from August 2022 to August 2023. As previously reported,6 the study population was racially and ethnically diverse, approximately half were first-time (52%) or Spanish-speaking (48%) mothers, and half were pregnant (versus postpartum). Of the 25 women in the parent study, five independently expressed without any explicit prompting that they saw value in providing MBapp to their partner. In this subgroup, 3/5 were Spanish-speaking, 2/5 were first-time mothers, and 3/5 were postpartum. Each of these five participants mentioned their interest in sharing MBapp with their partner when prompted to suggest ways to enhance the app’s usefulness for perinatal women.. The five women stated that the provision of MBapp to a partner would make it more effective as both a perinatal psychoeducational tool and a CBT-based program Each of these 5 participants was surprised that MBapp was planned to be delivered exclusively to the pregnant person.

Conclusions:

This qualitative analysis demonstrates that an evidence-based maternal PPD-prevention intervention may be more useful if delivered simultaneously to both parents and calls for additional research examining the feasibility and effectiveness of a digital, dyadic PPD prevention intervention. Clinical Trial: n/a