Women’s experiences of factors affecting treatment engagement and adherence in internet delivered Behavioural activation for postnatal depression
Open accessAbstract
Women with postnatal depression (PND) face significant barriers to treatment that may be overcome by internet based delivery of treatment. Demand for a self-help internet postnatal treatment offered via a parenting site was high, but attrition rates were also high. To gain patient perspectives on engagement and barriers to the Netmums' “Helping with Depression” treatment. Semi-structured interviews were conducted with 17 participants selected from the Netmums trial. Thematic analysis revealed motivators and barriers to treatment. Women reported that the flexibility and anonymity of internet interventions fit with their postnatal circumstances. They identified that the relevance of the intervention to their personal circumstances, expectations of motherhood, stigma about depression and motherhood, hopelessness about their ability to improve, previous negative experiences with treatment and treatment seeking, and a lack of practical and emotional support contributed to feelings of being overwhelmed. Women who felt more overwhelmed were more likely to discontinue treatment. Women suggested that support would reduce the impact of barriers and improve adherence. Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence.
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Interventions offering guidance by professionals, employing regular reminders, featuring fewer modules, and providing content tailored to individual needs and circumstances tend to have higher completion rates.
“Studies have indicated that interventions offering guidance by professionals, employing regular reminders, e.g. via telephone (Mu et al., 2021), featuring fewer modules (Westerhoff et al., 2019), providing content tailored to individual needs and circumstances tend to have higher completion rates (O'Mahen et al., 2015).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as O'Mahen et al., 2015
Section 3.1.1 reports that women were more likely to adhere when content fit their circumstances and that irrelevant examples sometimes led them to discontinue. The Discussion likewise says relevant content made women more likely to continue. The study supports a link between tailored content and adherence in this group, but does not establish higher completion rates across interventions. (LLM, conf=0.83)
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- Authors
- O'Mahen, H. A., Grieve, H., Jones, J., McGinley, J., Woodford, J., & Wilkinson, E. L.
- Affiliations
- University of Exeter (GB)
- Netmums Limited (United Kingdom) (GB)
- King's College London (GB)
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 2
- Issue
- 1
- Pages
- 84-90
- ISSN
- 2214-7829 (ISSN-L)
- OpenAlex
- W2000460587
- Cited by
- 53
- References
- 18
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 10 · 2022: 6 · 2021: 11 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 6 · 2016: 1 · 2015: 2
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health Research (NIHR)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- postpartum depression, behavioral activation, online intervention, treatment engagement, medication adherence, attrition, barriers to treatment, stigma, motherhood, help-seeking, self-help, parenting websites, women's experiences, support needs
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