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Davis JA, Ohan JL, Gregory S, Kottampally K, Silva D, Prescott SL, Finlay-Jones AL. Perinatal Women's Perspectives of, and Engagement in, Digital Emotional Well-Being Training: Mixed Methods Study. J Med Internet Res 2023; 25:e46852. [PMID: 37847537 PMCID: PMC10618893 DOI: 10.2196/46852] [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: 03/02/2023] [Revised: 07/30/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Psychological distress in the early postpartum period can have long-lasting deleterious effects on a mother's well-being and negatively affect her infant's development. Intervention approaches based in contemplative practices such as mindfulness and loving-kindness and compassion are intended to alleviate distress and cultivate well-being and can be delivered effectively as digital mental health interventions (DMHIs). OBJECTIVE To understand the feasibility of engaging perinatal women in digital interventions, this study aimed to document participants' experiences in the Mums Minds Matter (MMM) study, a pilot randomized controlled trial comparing mindfulness, loving-kindness and compassion, and progressive muscle relaxation training delivered in a digital format and undertaken during pregnancy. To assess the different stages of engagement during and after the intervention, we adapted the connect, attend, participate, enact (CAPE) framework that is based on the idea that individuals go through different stages of engagement before they are able to enact change. METHODS The MMM study was nested within a longitudinal birth cohort, The ORIGINS Project. We aimed to recruit 25 participants per randomization arm. Data were collected sequentially during the intervention through regular web-based surveys over 8 weeks, with opportunities to provide regular feedback. In the postintervention phase, qualitative data were collected through purposive sampling. RESULTS Of 310 eligible women, 84 (27.1% [connect rate]) enrolled to participate in MMM. Of the remaining 226 women who did not proceed to randomization, 223 (98.7%) failed to complete the baseline surveys and timed out of eligibility (after 30 weeks' gestation), and 3 (1.3%) displayed high psychological distress scores. Across all program groups, 17 (20% [attend rate]) of the 84 participants actively opted out, although more may have disengaged from the intervention but did not withdraw. The main reasons for withdrawal were busy life and other priorities. In this study, we assessed active engagement and ongoing skills use (participate and enact) through postintervention interviews. We undertook 15 participant interviews, conducted 1 month to 3 months after the intervention. Our results provide insights into participant barriers and enablers as well as app changes, such as the ability to choose topics, daily reminders, case studies, and diversity in sounds. Implementing a DMHI that is brief, includes frequent prompts or nudges, and is easily accessible is a key strategy to target perinatal women. CONCLUSIONS Our research will enable future app designs that are sufficiently nuanced to maximize the uptake, engagement, and application of mental health skills and contemplative practices in the perinatal period. Providing convenient access to engaging and effective prevention programs is critical and should be part of prenatal self-care. Our research underscores the appeal and feasibility of digital intervention approaches based in contemplative practices for perinatal women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) 12620000672954p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000672954p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19803.
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Affiliation(s)
- Jacqueline A Davis
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jeneva L Ohan
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Susan L Prescott
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Nova Institute for Health, Baltimore, MD, United States
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Hagemann E, Silva DT, Davis JA, Gibson LY, Prescott SL. Developmental Origins of Health and Disease (DOHaD): The importance of life-course and transgenerational approaches. Paediatr Respir Rev 2021; 40:3-9. [PMID: 34148804 DOI: 10.1016/j.prrv.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023]
Abstract
With well-established evidence that early life conditions have a profound influence on lifespan and health-span, new interventional birth cohorts are examining ways to optimise health potential of individuals and communities. These are aimed at going beyond preventing disease, to the conditions that facilitate flourishing from an early age. Covering diverse domains, local community projects, such as The ORIGINS Project, are taking a broader approach to the protective and buffering factors that enhance resilience and reduce allostatic load, such as building nature relatedness, interpersonal relationships, mindfulness, and positive emotions. Such cohorts aim to address how 'upstream' approaches will have flow on effects to the 'historical' risk targets (such as poor nutrition, physical inactivity, and stress) by influencing these core behaviours through better relationships with self, community, and the environment. In addition to scientific pursuit, interventional cohorts can contribute to solutions ineverycommunity - nourishing individuals and communities towards positive change.
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Affiliation(s)
- Erika Hagemann
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands WA 6009, PO Box 855, West Perth, WA 6872, Australia; Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia.
| | - Desiree T Silva
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands WA 6009, PO Box 855, West Perth, WA 6872, Australia; The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia; Joondalup Health Campus, Suite 210 Specialist Centre, 60 Shenton Avenue, Joondalup WA 6027, Australia; Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia
| | - Jacqueline A Davis
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands WA 6009, PO Box 855, West Perth, WA 6872, Australia; The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia
| | - Lisa Y Gibson
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands WA 6009, PO Box 855, West Perth, WA 6872, Australia; The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia; Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia
| | - Susan L Prescott
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Avenue, Nedlands WA 6009, PO Box 855, West Perth, WA 6872, Australia; The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia; Joondalup Health Campus, Suite 210 Specialist Centre, 60 Shenton Avenue, Joondalup WA 6027, Australia; Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia; inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States
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Davis JA, Gibson LY, Bear NL, Finlay-Jones AL, Ohan JL, Silva DT, Prescott SL. Can Positive Mindsets Be Protective Against Stress and Isolation Experienced during the COVID-19 Pandemic? A Mixed Methods Approach to Understanding Emotional Health and Wellbeing Needs of Perinatal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136958. [PMID: 34209693 PMCID: PMC8297209 DOI: 10.3390/ijerph18136958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022]
Abstract
The aim of this study was to explore the relationship between emotional health and wellbeing and support needs of perinatal women during the COVID-19 pandemic, and to understand their experiences and need for support. This is a potentially vulnerable group and a critical developmental phase for women and infants. A mixed methods design was used to collect quantitative and qualitative data that provided a robust insight into their unique needs. A total of 174 women who were either pregnant or post-birth participated. The main findings demonstrated that women in this cohort experienced varying levels of stress and isolation but also positive experiences. Exploring the relationship between mental health (perceived stress and wellbeing) and resilience (mindfulness and self-compassion) revealed an association between positive mental health and higher levels of mindfulness and self-compassion. Positive mindsets may be protective against psychological distress for the mother and her child, suggesting that meditation-based or similar training might help support expectant and post-birth mothers during times of crisis, such as a pandemic. This information could be used to make recommendations for future planning for practitioners and policymakers in preparing for prospective infection waves, pandemics, or natural disasters, and could be used to develop targeted tools, support, and care.
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Affiliation(s)
- Jacqueline A. Davis
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
- Correspondence:
| | - Lisa Y. Gibson
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Natasha L. Bear
- Institute for Health Research, Notre Dame University, Fremantle, WA 6160, Australia;
| | - Amy L. Finlay-Jones
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
| | - Jeneva L. Ohan
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
| | - Desiree T. Silva
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
- Joondalup Health Campus, Joondalup, WA 6027, Australia
| | - Susan L. Prescott
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
- Institute for Health Research, Notre Dame University, Fremantle, WA 6160, Australia;
- inVIVO Planetary Health, Worldwide Universities Network (WUN), West New York, NJ 10704, USA
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