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Tung I, Balaji U, Hipwell AE, Low CA, Smyth JM. Feasibility and acceptability of measuring prenatal stress in daily life using smartphone-based ecological momentary assessment and wearable physiological monitors. J Behav Med 2024:10.1007/s10865-024-00484-4. [PMID: 38581594 DOI: 10.1007/s10865-024-00484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/10/2024] [Indexed: 04/08/2024]
Abstract
High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10 hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy.
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Affiliation(s)
- Irene Tung
- Department of Psychology, California State University, Dominguez Hills, 1000 E. Victoria Street, Carson, CA, 90747, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Uma Balaji
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carissa A Low
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joshua M Smyth
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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Khosravi M, Azar G. A systematic review of reviews on the advantages of mHealth utilization in mental health services: A viable option for large populations in low-resource settings. Glob Ment Health (Camb) 2024; 11:e43. [PMID: 38690573 PMCID: PMC11058521 DOI: 10.1017/gmh.2024.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 05/02/2024] Open
Abstract
Global mental health services face challenges such as stigma and a shortage of trained professionals, particularly in low- and middle-income countries, which hinder access to high-quality care. Mobile health interventions, commonly referred to as mHealth, have shown to have the capacity to confront and solve most of the challenges within mental health services. This paper conducted a comprehensive investigation in 2024 to identify all review studies published between 2000 and 2024 that investigate the advantages of mHealth in mental health services. The databases searched included PubMed, Scopus, Cochrane and ProQuest. The quality of the final papers was assessed and a thematic analysis was performed to categorize the obtained data. 11 papers were selected as final studies. The final studies were considered to be of good quality. The risk of bias within the final studies was shown to be in a convincing level. The main advantages of mHealth interventions were categorized into four major themes: 'accessibility, convenience and adaptability', 'patient-centeredness', 'data insights' and 'efficiency and effectiveness'. The findings of the study suggested that mHealth interventions can be a viable and promising option for delivering mental health services to large and diverse populations, particularly in vulnerable groups and low-resource settings.
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Affiliation(s)
- Mohsen Khosravi
- Department of Healthcare Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghazaleh Azar
- Department of Consultation and Mental Health, Yasuj University of Medical Sciences, Yasuj, Iran
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Liblub S, Pringle K, McLaughlin K, Cummins A. Peer support and mobile health for perinatal mental health: A scoping review. Birth 2024. [PMID: 38268345 DOI: 10.1111/birt.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Up to one in five women experience perinatal depression and/or anxiety with profound negative consequences for mothers and families. Peer support interventions have the potential to effectively prevent perinatal mental health conditions. Meanwhile, mobile health has gained popularity and plays a significant role in enhancing maternal health services. However, little is known about the availability of mobile health combined with peer support for supporting perinatal mental health. This scoping review aimed to map the relevant literature and gain insights into the available evidence on mobile health and peer support for perinatal mental health, to identify gaps and inform opportunities for future research. METHODS A scoping review of the literature was conducted. The search strategy included five databases: CIANHL, Scopus, PsycInfo, PubMed, and ScienceDirect for the period from 2007 to 2022. RESULTS Eight studies met the inclusion criteria, including features of online support strategies, effectiveness, and attitudes of women about peer support with mobile health. The results showed decreased depressive scores and provided a positive experience for women. Strong satisfaction with accessibility and flexibility of mobile health was found when combined with the peer support features. Additional emotional support tools (e.g., mindfulness-based activities) were likely to be acceptable to women and beneficial to mobile health. CONCLUSIONS Understanding the context of peer support and mobile health informs the potential to support perinatal mental health. Further research in this growing area is needed to test the effectiveness of peer support in combination with mobile health intervention for supporting perinatal mental health.
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Affiliation(s)
- Sudjit Liblub
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kirsty Pringle
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Biomedical Sciences and Pharmacy, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Karen McLaughlin
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Allison Cummins
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Hernandez-Green N, Davis MV, Farinu O, Hernandez-Spalding K, Lewis K, Beshara MS, Francis S, Baker LJ, Byrd S, Parker A, Chandler R. Using mHealth to reduce disparities in Black maternal health: Perspectives from Black rural postpartum mothers. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241239769. [PMID: 38773870 PMCID: PMC11113071 DOI: 10.1177/17455057241239769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND Racial disparities are evident in maternal morbidity and mortality rates globally. Black women are more likely to die from pregnancy and childbirth than any other race or ethnicity. This leaves one of the largest gaps in women's health to date. OBJECTIVES mHealth interventions that connect with women soon after discharge may assist in individualizing and formalizing support for mothers in the early postpartum period. To aid in developing an mHealth application, Black postpartum mothers' perspectives were examined. DESIGN Utilizing the Sojourner Syndrome Framework and Maternal Mortality & Morbidity Measurement Framework, group interview discussion guides were developed to examine the facilitators and barriers of postpartum transitional care for rural Black women living in the United States to inform the development of a mobile health application. METHODS In this study, seven group interviews were held with Black mothers, their support persons, and healthcare providers in rural Georgia to aid in the development of the Prevent Maternal Mortality Using Mobile Technology (PM3) mobile health (mHealth) application. Group interviews included questions about (1) post-birth experiences; (2) specific needs (e.g. clinical, social support, social services, etc.) in the postpartum period; (3) perspectives on current hospital discharge processes and information; (4) lived experiences with racism, classism, and/or gender discrimination; and (5) desired features and characteristics for the mobile app development. RESULTS Fourteen out of the 78 screened participants were eligible and completed the group interview. Major discussion themes included: accessibility to healthcare and resources due to rurality, issues surrounding race and perceived racism, mental and emotional well-being in the postpartum period, and perspectives on the PM3 mobile application. CONCLUSION Participants emphasized the challenges that postpartum Black women face in relation to accessibility, racism and discrimination, and mental health. The women favored a culturally relevant mHealth tool and highlighted the need to tailor the application to address disparities.
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Affiliation(s)
| | | | - Oluyemi Farinu
- Health Equity Researcher and Sociologist, Atlanta, GA, USA
| | | | - Kennedy Lewis
- Emory University and Georgia Health Policy Center, Georgia State University, Atlanta, GA, USA
| | | | | | - LeThenia Joy Baker
- Wellstar Medical Group, Wellstar West Georgia Medical Center, LaGrange, GA, USA
| | | | - Andrea Parker
- School of Interactive Computing, Wellness Technology Lab, Georgia Institute of Technology, Atlanta, GA, USA
| | - Rasheeta Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Salameh TN, Nyakeriga DB, Hall LA. Telehealth Care for Perinatal Depression in Immigrant and Refugee Women: A Scoping Review. Issues Ment Health Nurs 2023; 44:1216-1225. [PMID: 37832145 DOI: 10.1080/01612840.2023.2258222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Immigrant and refugee women have higher rates of perinatal depression compared to native-born women. Innovative telehealth interventions provide opportunities for prevention and treatment of perinatal depression. However, little is known about telehealth for perinatal immigrant and refugee women with depression. The aims of this scoping review were to identify available literature addressing the use of telehealth care for perinatal depression in immigrant and refugee women, and to determine the content, mode of delivery, and outcomes of telehealth care when provided for this population. A systematic literature search from 2000 to July 2023 was conducted in six databases and grey literature. The initial search resulted in 988 articles which were screened for their titles and abstracts. Eighty-one full-text articles were reviewed, yielding five articles included in this review. One quantitative study (a feasibility descriptive study), three qualitative studies, and a commentary supported the user satisfaction and potential effectiveness of telehealth care, delivered via telephone and text messaging, in improving perinatal depression symptoms. This review revealed a dearth of data-based studies on the outcomes of telehealth care for perinatal depression among immigrant and refugee women. Collaboration among researchers, healthcare providers, and technology engineers is required to improve telehealth care for this population.
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Affiliation(s)
- Taghreed N Salameh
- School of Nursing Women's Health Department, Koç University, İstanbul, Turkey
| | | | - Lynne A Hall
- School of Nursing, University of Louisville, Louisville, Kentucky, USA
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Wada A, Nakamura Y, Kawajiri M, Takeishi Y, Yoshida M, Yoshizawa T. Feasibility and Usability of the Job Adjustment Mobile App for Pregnant Women: Longitudinal Observational Study. JMIR Form Res 2023; 7:e48637. [PMID: 37962945 PMCID: PMC10685280 DOI: 10.2196/48637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Working pregnant women often need to adjust their physically demanding jobs for a healthy pregnancy. However, uncertainty about the extent of these adjustments can hinder their effectiveness. To address this, we developed the Job Adjustment mobile app, which allows users to input job and health details to generate a variety of personalized action plans. As this is the first version of the app, assessing its feasibility and usability is crucial. OBJECTIVE This study aims to verify the feasibility and usability of the Job Adjustment mobile app. METHODS A longitudinal observational study was conducted on pregnant Japanese women who were allowed to use the app anytime from 12 to 34 weeks of gestation; they received reminder emails every 2 weeks encouraging app use. A questionnaire was administered before app use and at 20 and 32 weeks of gestation. Feasibility was evaluated across 4 domains: implementation, demand, acceptability, and adverse events. Implementation was evaluated based on 3 parameters: dropout rate, initial reminder email receipt rate, and adherence rate (measured as pregnant women who used the app at intervals of 2.5 weeks or less). Demand was measured by intervals between use and intervals between log-in, and participants answered 15 questions to assess acceptability. Adverse events were assessed by analyzing the degree of anxiety related to work. Demographic data were analyzed to determine any statistically significant differences in intervals between uses. Usability was evaluated using the System Usability Scale. RESULTS The analysis included 66 pregnant women, and 61% (n=40) of them were multipara. The dropout rate, adherence rate, and initial reminder email receipt rate were 18% (13/71), 44% (29/66), and 79% (52/66) respectively. The median intervals between use and intervals between log-in were 2.94 (IQR 2.00-5.13) weeks and 2.28 (IQR 1.81-4.00) weeks, respectively. Overall, 60% (35/58) to 90% (52/58) of the participants responded positively to all 15 questions assessing acceptability, and no anxiety regarding work was recorded. The mean System Usability Scale score was 66.1 points. Multipara women had significantly longer intervals between app use compared to primipara women (P=.01). CONCLUSIONS The results demonstrated acceptable levels of feasibility and usability of the app. However, the low adherence rates, especially among multipara women, suggest the need for modifications to reduce the time burden of the app. Further research should explore more effective and acceptable intervals between use and timing, involving a larger sample and accounting for diverse characteristics of pregnant women. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000042943; https://tinyurl.com/ydrchfas.
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Affiliation(s)
- Aya Wada
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
| | - Yasuka Nakamura
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Maiko Kawajiri
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yoko Takeishi
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Toyoko Yoshizawa
- Health Sciences Department of Nursing, Kansai University of International Studies, Miki, Hyogo, Japan
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Xie EB, Jung JW, Kaur J, Benzies KM, Tomfohr-Madsen L, Keys E. Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies. J Med Internet Res 2023; 25:e43219. [PMID: 37494086 PMCID: PMC10413237 DOI: 10.2196/43219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. OBJECTIVE This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. METHODS A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. CONCLUSIONS New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
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Affiliation(s)
| | - James Wonkyu Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jasleen Kaur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- School of Nursing, The University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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Arakawa Y, Haseda M, Inoue K, Nishioka D, Kino S, Nishi D, Hashimoto H, Kondo N. Effectiveness of mHealth consultation services for preventing postpartum depressive symptoms: a randomized clinical trial. BMC Med 2023; 21:221. [PMID: 37365535 DOI: 10.1186/s12916-023-02918-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Although many conventional healthcare services to prevent postpartum depression are provided face-to-face, physical and psychosocial barriers remain. These barriers may be overcome by using mobile health services (mHealth). To examine the effectiveness of mHealth professional consultation services in preventing postpartum depressive symptoms in real-world settings, we conducted this randomized controlled trial in Japan, where universal free face-to-face perinatal care is available. METHODS This study included 734 pregnant women living in Yokohama city who could communicate in Japanese, recruited at public offices and childcare support facilities. The participants were randomized to the mHealth group (intervention, n = 365), where they could use a free app-based mHealth consultation service with gynecologists/obstetricians, pediatricians, and midwives whenever and as many times as they wanted between 6 p.m. and 10 p.m. on weekdays throughout their pregnancy and postpartum periods (funded by the City of Yokohama government) or the usual care group (control, n = 369). The primary outcome was the risk of elevated postpartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale score ≥ 9. Secondary outcomes were self-efficacy, loneliness, perceived barriers to healthcare access, number of clinic visits, and ambulance usage. All outcomes were collected three months post-delivery. We also conducted subgroup analyses assessing the differences in the treatment effect by sociodemographic status. RESULTS Most women completed all questionnaires (n = 639 of 734, response rate: 87%). The mean baseline age was 32.9 ± 4.2 years, and 62% were primipara. Three months post-delivery, women in the mHealth group had a lower risk of elevated postpartum depressive symptoms (47/310 [15.2%]) compared to the usual care group (75/329 [22.8%], risk ratio: 0.67 [95% confidence interval: 0.48-0.93]). Compared with the usual care group, women in the mHealth group had higher self-efficacy, less loneliness, and fewer perceived barriers to healthcare access. No differences were observed in the frequency of clinic visits or ambulance usage. Furthermore, in the subgroup analyses, we did not find differences in the treatment effect by sociodemographic status. CONCLUSIONS Local government-funded mHealth consultation services have a preventive effect on postpartum depressive symptoms, removing physical and psychological barriers to healthcare access in real-world settings. TRIAL REGISTRATION UMIN-CTR identifier: UMIN000041611. Registered 31 August 2021.
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Affiliation(s)
- Yuki Arakawa
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Maho Haseda
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Daisuke Nishioka
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan.
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Amaro JS, Pessalli MRTFB, da Cunha LB, Betrán AP, Torloni MR, Siaulys MM. The Godmother Project: A Virtual Initiative to Support Pregnant and Postpartum Women in Brazil During the COVID-19 Pandemic. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2200500. [PMID: 37116933 PMCID: PMC10141421 DOI: 10.9745/ghsp-d-22-00500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/15/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND The COVID-19 pandemic increased maternal distress and demand for social support and educational services, while restriction measures decreased the availability of these services. PROJECT DESCRIPTION The Godmother Project, a person-centered, WhatsApp-based support and health education initiative, was created after all in-person perinatal educational activities offered at 3 Brazilian hospitals were canceled in 2020. The project was developed in response to pregnant/postpartum women who called the hospitals with questions for health care professionals (HCPs). Health education nurses teamed up with staff from the communication department to design a project to (1) provide a direct communication channel between women and HCPs to answer health-related questions, (2) offer reliable virtual health education material, (3) identify women in need of additional assessment/referrals, (4) offer each woman continuous support from a specific nurse educator (Godmother), and (5) offer a virtual forum where women going through similar experiences could interact. PROJECT DEVELOPMENT AND ROLLOUT The project provides direct communication between WhatsApp groups of 25-30 pregnant/postpartum women and a Godmother. It also offers access to a virtual library of educational materials prepared in response to women's needs/demands. The project, which began in July 2020 with 1 WhatsApp group of 5 women and 1 Godmother, currently has 305 groups, 6,942 active participants, and 4 Godmothers. Enrollments and WhatsApp groups continued to increase despite reestablishment of in-person educational activities in 2022. The vast majority of 232 participants surveyed in December 2021 were very satisfied with the project, the Godmothers, and the educational materials. CONCLUSIONS Our findings suggest that WhatsApp groups of pregnant/postpartum women led by dedicated nurse educators can be an important tool to educate and support women during the perinatal period. This type of initiative may be especially important in contexts of physical distancing requirements or situations where social support is unavailable.
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Affiliation(s)
- Juliana S Amaro
- Communication and Marketing Department, Grupo Santa Joana, São Paulo, Brazil
| | | | - Lissandra B da Cunha
- Department of Health Education and Training, Grupo Santa Joana, São Paulo, Brazil
| | - Ana Pilar Betrán
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Hulsbosch LP, Potharst ES, Schwabe I, Boekhorst MGBM, Pop VJM, Nyklíček I. Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial. J Affect Disord 2023; 332:262-272. [PMID: 37054897 DOI: 10.1016/j.jad.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Pregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. METHODS Pregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. RESULTS Significant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LIMITATIONS Low adherence to the intervention and assessment of secondary outcome measures in the intervention group only. CONCLUSIONS An intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. TRIAL REGISTRATION ClinicalTrials.gov: NCT03917745, registered on 4 March 2019.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands.
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, the Netherlands
| | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
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11
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Olajubu AO, Fajemilehin BR, Olajubu TO. Mothers’ experiences with mHealth intervention for postnatal care utilisation in Nigeria: a qualitative study. BMC Pregnancy Childbirth 2022; 22:843. [PMCID: PMC9670477 DOI: 10.1186/s12884-022-05177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 10/10/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
The postnatal period implies a crucial and delicate time for both the mother and the newborn. There is a growing body of evidence that is increasingly pointing to mHealth interventions as a potential tool for improved utilisation of maternal and child health services, including postnatal care. This can promote the health of mother and baby during this delicate period. However, the success of the interventions must be explored to validate their usefulness and reliability. Hence, this study explored the experiences of postpartum women on the usefulness of the mHealth intervention (postnatal care assistant) they received.
Methods
Twenty women, who were involved in mHealth intervention were interviewed using a semi-structured interview guide. They were recruited from the intervention group of a quasi-experimental study that evaluated the effect of a mHealth intervention on the uptake of postnatal care services. Thematic analysis of data was done using NVivo software version 10.
Results
Five major themes emerged from data shared by the participants. They are general feelings about the messages, benefits derived from the messages about pregnancy and hospital delivery, increased knowledge about baby care, facilitation of PNC utilisation and involvement of significant others in decision making. They affirmed that the information and reminder messages gave them the impetus to utilise postnatal care services.
Conclusion
Mothers reported that mHealth intervention provided immense support and assistance during pregnancy and the reminder messages encouraged them to utilise postnatal care services. This study suggests that improved education and reminder messages via mobile phones are needed during pregnancy and after childbirth to promote mother and child health through the utilization of postnatal care services, and efforts to put this approach to action should be pursued.
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Martínez Herreros MC, Rodríguez Muñoz MF, Izquierdo Méndez N, Olivares Crespo ME. Psychological, Psychosocial and Obstetric Differences between Spanish and Immigrant Mothers: Retrospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11782. [PMID: 36142058 PMCID: PMC9517456 DOI: 10.3390/ijerph191811782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
This study analyzed the influence of psychological and psychosocial factors of pregnant women at an obstetric level. The possible differences between Spaniards and immigrants were studied. This was a retrospective observational study. The sample has been divided into two study cohorts, one consisting of Spanish pregnant women and one consisting of foreign pregnant women. Both completed the Revised Postpartum Depression Predictors Inventory and the Patient Health Questionnaire-9. A total of 15.9% of Spanish women and 23.2% of immigrants had depressive symptoms. Immigrants claim to have less support at the partner, family, and friendship levels than Spaniards. Moreover, 16.4% of Spaniards vs. 8.1% of immigrants had pregnancy complications; Cesarean section was performed in 16.2% of Spaniards vs. 7.9% of immigrants. A greater number of premature births were detected in immigrants than in Spaniards. Access to universal healthcare is a protective factor against socioeconomic and cultural conditions affecting the mental and obstetrical health of immigrants.
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Affiliation(s)
- María Carmen Martínez Herreros
- Department of Psychology, National University of Distance Education (UNED), C/Juan del Rosal No. 10, 28040 Madrid, Spain
| | - María Fe Rodríguez Muñoz
- Department of Psychology, National University of Distance Education (UNED), C/Juan del Rosal No. 10, 28040 Madrid, Spain
| | - Nuria Izquierdo Méndez
- Department of Obstetrics and Gynecology, San Carlos Clinic Hospital, 28040 Madrid, Spain
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