Accepted for/Published in: JMIR Human Factors
Date Submitted: Aug 5, 2025
Date Accepted: Mar 20, 2026
Feasibility and Acceptability of a Prevention-Focused Screener for Perinatal Depression Risk: Mixed Methods Cohort Study
ABSTRACT
Background:
Over 20% of perinatal individuals experience depression, with suicide being a leading cause of US maternal death. Professional societies emphasize the need to identify those at risk of developing perinatal depression to better target preventive care delivery during pregnancy.
Objective:
We evaluated patient receptivity to a machine learning-based predictive screener designed to identify asymptomatic first-trimester patients who are at risk for developing moderate-to-severe depression symptoms later in their pregnancy.
Methods:
Our population included adult pregnant patients with negative first-trimester depression/ PHQ-9 screens. Of the 810 clinically eligible patients, 787 were successfully contacted. Of these 289 (37%) viewed and 255 (88%) completed the 6-question predictive screener sent via their patient portal. Fifty-one (20%) were identified by the screener as at-risk for developing peripartum depression.
Results:
On a 5-point Likert scale of agreement, participants found screener questions easy to complete (mean (SD)=4.70 (0.66)) and felt comfortable sharing answers with providers (4.54 (0.77)). Key perceived benefits of completing the screener included seeking preventive care opportunities (75/255, 29.4%) and receiving education on depression risk (66/255, 25.9%). Primary concerns of knowing one’s risk of future depression included worrying about developing depression (90/255, 35.3%) and a lack of prevention opportunities (39/255, 15.3%). Desired preventive resources included counseling (197/255, 77.3%), mind/body interventions (166/255, 65.1%), such as exercise, and prenatal classes/support groups (81/255, 31.8%).
Conclusions:
Most patients accessing the screener completed it and offered feedback. Participants found the screener acceptable and felt comfortable receiving it through their patient portal. Patients endorsed specific preventive care options, several of which were scalable and evidence-based, while a minority voiced addressable concerns about knowing their risk of developing depression in the future.
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