Digital Health Technologies for Peripartum Depression Management Among Low-Socioeconomic Status Populations: A Qualitative Analysis of Patient, Provider, and Social Media Perspectives. (Preprint)
Authors: Zingg Alexandra , Singh Tavleen , Franklin Amy , Ross Angela , Myneni Sahiti 
Published: September 2022

BACKGROUND

Peripartum Depression (PPD) affects approximately 1 in 10 pregnant women and 1 in 8 new mothers in the U.S. every year, representing a significant population. Women of low socioeconomic status (low-SES) are more likely to develop PPD symptoms. Multilevel treatment barriers including, but not limited to, social stigma, misguided expectations on the role of motherhood, and not having appropriate PPD knowledge or access to mental health resources have played a major role in PPD-related disparities. Emerging advances in digital technologies and analytics provide us with opportunities to address access barriers, knowledge gaps, and engagement issues. However, the majority of digital market solutions currently available are produced in a generic manner and do not consider the information and technology needs of low-SES populations.

OBJECTIVE

In this research study, we describe our qualitative approach towards evaluating low-SES women and providers’ current experiences with digital management of perinatal mental health, and supplement this with information gathered from participants in PPD-related online forums.

METHODS

We have conducted (a) 2 focus groups (n= 9), (b) semi-structured interviews with care providers (n= 9) and low SES women (n= 10), as well as (c) secondary analysis of online forum messages (n= 1,424). Qualitative data were inductively analyzed using grounded theory, where we first perform line-by-line open coding of the data and then discover key PPD information and technology user needs through identifying patterns and relationships among core concepts.

RESULTS

Our qualitative analysis resulted in a total of 134 open codes from patient interviews, 185 from provider interviews, and 106 from focus groups. These revealed six core themes for PPD management: 1) “Use of Technology/Features”, 2) “Access to Care”, 3) “Pregnancy Education”, 4) “Social and Community Support”, 5) “Sources of information”, and 6) “Digital Data”. Two themes that were uniquely brought up by providers were “Managerial and Administrative Support for Providers” and “Peripartum Depression Clinical Decision Support”. Our social media analysis revealed the following six PPD topics of importance in online messages: “Physical and Mental Health” (50.9% of messages), “Social Support” (47.3%), “Medications” (42.9%), “Mother and Infant Dyad” (32.3%), “Family and Friends” (30.1%), and “Doctor and Patient Dyad” (29.7%).

CONCLUSIONS

Our triangulation of data allowed us to analyze PPD information and technology needs at different levels of granularity. Differences between patient and provider included a focus from providers on needing better support from administrative staff, as well as better PPD clinical decision support. Our social media analysis provided us with insights into PPD topics of interest being discussed by a broader sample of women participating in an online community. Our results can inform future research and development efforts to address PPD health disparities among low-SES perinatal women.