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Cited by 42Maternal Mental Health During Pregnancy and PostpartumDigital Mental Health InterventionsMobile Health and mHealth Applications

An Integrated Web-Based Mental Health Intervention of Assessment-Referral-Care to Reduce Stress, Anxiety, and Depression in Hospitalized Pregnant Women With Medically High-Risk Pregnancies: A Feasibility Study Protocol of Hospital-Based Implementation

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Kingston, Dawn, Janes-Kelley, Selikke, Tyrrell, Janie, Clark, Lorna, Hamza, Deena, Holmes, Penny, Parkes, Cheryl, Moyo, Nomagugu +2 more·2015·JMIR Research Protocols
DOI 10.2196/resprot.4037PMC PMC4319085
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Abstract

BACKGROUND: At prevalence rates of up to 40%, rates of depression and anxiety among women with medically complex pregnancies are 3 times greater than those in community-based samples of pregnant women. However, mental health care is not a component of routine hospital-based antenatal care for medically high-risk pregnant women. OBJECTIVE: The purpose of this study is to evaluate the effectiveness and feasibility of the hospital-based implementation of a Web-based integrated mental health intervention comprising psychosocial assessment, referral, and cognitive behavioral therapy (CBT) for antenatal inpatients. METHODS: This study is a quasi-experimental design. Pregnant women are eligible to participate if they are (1) <37 weeks gestation, (2) admitted to the antenatal inpatient unit for >72 hours, (3) able to speak and read English or be willing to use a translation service to assist with completion of the questionnaires and intervention, (4) able to complete follow-up email questionnaires, (5) >16 years of age, and (6) not actively suicidal. Women admitted to the unit for induction (eg, <72-hour length of stay) are excluded. A minimum sample of 54 women will be recruited from the antenatal high-risk unit of a large, urban tertiary care hospital. All women will complete a Web-based psychosocial assessment and 6 Web-based CBT modules. Results of the psychosocial assessment will be used by a Web-based clinical decision support system to generate a clinical risk score and clinician prompts to provide recommendations for the best treatment and referral options. The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6-8 weeks postrecruitment. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence at 3-months postpartum; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. All women will complete email questionnaires at 6-8 weeks postrecruitment and 3-months postpartum. Qualitative interviews with 10-15 health care providers and 15-30 women will provide data on feasibility and acceptability of the intervention. RESULTS: The study was funded in September, 2014 and ethics was approved in November, 2014. Subject recruitment will begin January, 2015 and results are expected in December, 2015. Results of this study will determine (1) the effectiveness of an integrated Web-based prenatal mental health intervention on maternal and infant outcomes and (2) the feasibility of implementation of the intervention on a high-risk antenatal unit. CONCLUSIONS: This study will provide evidence and guidance regarding the implementation of a Web-based mental health program into routine hospital-based care for women with medically high-risk pregnancies.

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  • Perinatal women have not been frequently included in computer-based treatment research.

    “perinatal women have not been frequently included.35–37”

    From Pregnancy and the Acceptability of Computer-Based Versus Traditional Mental Health Treatments (2017) · cites this paper as [37]

    The Introduction’s “Web-Based Cognitive Behavioral Therapy” section says that, to the authors’ knowledge, only one trial of web-based CBT during pregnancy was in progress, supporting limited research involving pregnant women. It also mentions early evidence for postnatal depression, but does not establish how frequently perinatal women were included in computer-based treatment research more broadly. (LLM, conf=0.82)

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Authors
Kingston, D., Janes-Kelley, S., Tyrrell, J., Clark, L., Hamza, D., Holmes, P., Parkes, C., Moyo, N., McDonald, S., & Austin, M.-P.
Affiliations
  • University of Alberta (CA)
  • Alberta Health Services (CA)
  • UNSW Sydney (AU)
Corresponding author
Kingston, Dawn
ORCID
Venue
JMIR Research Protocols
Publisher
JMIR Publications Inc.
Published
2015-01-16
Volume
4
Issue
1
Pages
e9
ISSN
1929-0748 (ISSN-L)
DOI
10.2196/resprot.4037
PMC
PMC4319085
OpenAlex
W2164568274
Cited by
42
References
23
Citations by year
2026: 1 · 2024: 8 · 2022: 5 · 2021: 2 · 2020: 8 · 2019: 5 · 2018: 1 · 2017: 6 · 2016: 2 · 2015: 4
FWCI
4.65
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Research Protocols (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Children's Health Research Institute
  • Royal Alexandra Hospital Foundation
  • Strong
  • University of Alberta
  • Canadian Institutes of Health Research
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
antenatal depression, prenatal anxiety, prenatal stress, cognitive behavioral therapy, psychosocial assessment, clinical decision support systems, postpartum depression, maternal-infant attachment, parental stress, feasibility and acceptability, cost-effectiveness, maternal mental health care, prenatal care, self-efficacy

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