Integrating human‐centred design into the development of an intervention to improve the mental wellbeing of young women in the perinatal period: the Catalyst project

Abstract

Background Mental wellbeing during pregnancy and the year after birth is critical to a range of maternal and infant outcomes. Many mental health interventions fail to incorporate stakeholder perspectives. The Catalyst Project aimed to work with key stakeholders in Mozambique to develop interventions and delivery strategies which were in-line with existing evidence and the needs, goals, and priorities of those both directly and indirectly involved in its success. Methods A qualitative, human-centred design approach was utilised. Focus-group discussions, individual interviews, and observations with young women (aged 16–24 years), their families, community leaders, service providers and government were used to better understand the needs, priorities and challenges to mental wellbeing of young women. These findings were triangulated with the literature to determine priority challenges to be addressed by an intervention. Stakeholder workshops were held to identify potential solutions and co-develop an intervention and delivery strategy. Results The 65 participants comprised 23 young pregnant women or new mothers, 12 family members, 19 service providers and 11 staff from the Ministry of Health. Participants highlighted significant uncertainty related to living situations, financial status, education, social support, and limited knowledge of what to expect of the impact of pregnancy and parenting. Family and community support were identified as an important need among this group. The Mama Felíz (Happy Mama) programme was developed with stakeholders as a course to strengthen pregnancy, childbirth and child development knowledge, and build positive relationships, problem-solving and parenting skills. In addition, family sessions address wider cultural and gender issues which impact adolescent maternal wellbeing. Conclusions We have developed an intervention to reduce the risk of poor maternal mental health and gives young mothers hope and skills to make a better life for them and their children by packaging information about the risk and protective factors for maternal mental disorders in a way that appeals to them, their families and service providers. By using human-centred design to understand the needs and priorities of young mothers and the health and community systems in which they live, the resulting intervention and delivery strategy is one that stakeholders view as appropriate and acceptable.

Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis

“…The expansion of support and care within MCH services and outside of health services (e.g., community-based services, traditional healers, religious organizations) can be effectively achieved by upskilling non mental health specialist providers to provide mental health promotion, prevention, and treatment interventions (World Health Organization, 2021a). Research, such as that from Taylor Salisbury et al (2021), ought to be undertaken on how to integrate the community-based non-specialist workforce with existing systems and places where women would interact with support with services in the community (Taylor Salisbury et al, 2021). Ultimately, we need to work with women in the community to understand where women go to find places of support and connection and undertake research seeking to understand from women themselves what they would like to receive as services/supports and how they would like to receive them.…”

Development and functioning of the mobile app-based mh-GAP intervention guide in detection and treatment of people with mental health conditions in primary healthcare settings in Nepal

“…This approach brings end-users and developers together to co-create interventions and delivery strategies (Bazzano et al, 2017). This method has also been used in the development of a range of user-friendly mental health interventions, for example, a WHO transdiagnostic chatbot for distressed youth (Hall et al, 2022), evidence-based psychotherapies in low-resource settings (Lyon and Koerner, 2016), and mental health support for adolescent mothers in Mozambique (Taylor Salisbury et al, 2021a).…”

Protocol for intervention development to improve adolescent perinatal mental health in Kenya and Mozambique: The INSPIRE project

“…Human-centred design is a participatory approach which actively engages stakeholders throughout intervention planning, preparation, delivery, and evaluation using methods to and (e) Test -evaluating and further refinement. In the last decade, humancentred design has begun to be used within global health (including mental health) research (Bazzano et al, 2017;Chen et al, 2020;Fakoya et al, 2021;IDEO.org, 2015;Taylor Salisbury et al, 2021).…”