Scaling up Mental Healthcare for Perinatal Populations: Is Telemedicine the Answer?

Singla, Daisy R.; Savel, Katarina; Kim, Jo; Silver, Richard K.; Vigod, Simone N.; Dalfen, Ariel; Meltzer‐Brody, Samantha

doi:10.1007/s11920-022-01389-2

Cited by 8 publications

(3 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no difference in rates of perinatal or postpartum depression between groups, though rates of depression were lower than predicted (< 3%, whereas a 5% rate was predicted) in both groups, which suggests the study may have been underpowered to detect a difference [45•]. This (i.e., study size) reflects one of several ongoing issues in the evaluation of telemedicine and perinatal mental health, in addition to concerns surrounding patient acceptability of remote management and how to account appropriately for comorbid trauma and substance use in patients with perinatal mood disorders [46].…”

Section: Postpartum Carementioning

confidence: 99%

Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

Stone,

Hirshberg

2024

Curr Obstet Gynecol Rep

View full text Add to dashboard Cite

Purpose of Review Telemedicine and digital health platforms are now integral to the way patients and clinicians interact with the health system. Application of these technologies in the antepartum context is well studied and accepted. The purpose of this review is to outline the state of telemedicine and digital health solutions in the intrapartum and postpartum period, understanding applications for labor and the months following delivery. Recent Findings Telemedicine can be used in the intrapartum period to assist with staffing shortages, remote assessment of intrapartum fetal heart tracings, and doula support. Application in the postpartum period includes but is not limited to remote blood pressure monitoring, lactation support, mental health screening and treatment, and substance use disorder. Summary Both telemedicine and digital health solutions aim to augment, not replace, care relationship during pregnancy, delivery, and postpartum. Whether these tools advance intrapartum and postpartum care remains subject to the same contingencies present in other specialties and care contexts. Ongoing investment into the application and evaluation of telemedicine and digital health solutions throughout pregnancy should be prioritized.

show abstract

Section: Postpartum Carementioning

confidence: 99%

Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

Stone,

Hirshberg

2024

Curr Obstet Gynecol Rep

View full text Add to dashboard Cite

show abstract

“…[45][46] ■ Conclusion Given shortages of mental health care providers, stigma associated with mental health treatment, and long referral times, health policymakers are calling for colocated mental health services to be provided where individuals are receiving prenatal care. [47][48][49][50][51][52] Studies have demonstrated that CBT is an eff ective intervention for improving mental health in Black and Hispanic pregnant people, but when CBT is provided separately from prenatal care, it can be burdensome and difficult to access. 52 Work is ongoing to identify culturally acceptable, nonburdensome ways to incorporate CBT and other interventions into prenatal care.…”

Section: Implications For Practicementioning

confidence: 99%

Depression, anxiety, and stress in pregnant Black people

Gennaro,

Melnyk,

Szalacha

et al. 2023

The Nurse Practitioner

View full text Add to dashboard Cite

Background: Guidelines call for pregnant people to be screened for depression and anxiety. Screening may be particularly important for pregnant Black individuals who are reported to be more likely than non-Hispanic White pregnant people to experience prenatal stress, anxiety, and depressive symptoms. The purpose of this study was to determine if depression, anxiety, and stress co-occur in pregnant Black people and to identify which demographic factors are related to these mental health concerns. Methods: A subset analysis of an ongoing randomized controlled trial examined the risk of coexisting mental health conditions in pregnant Black people who screened eligible to participate (that is, they had high levels of depression, anxiety, and/or stress) in two urban clinics using a descriptive correlational design. Results: Of the 452 pregnant Black people who were screened for eligibility, 194 (42.9%) had elevated scores on depression, anxiety, and/or stress measures and were enrolled in the larger study. The average scores of the 194 enrolled participants were anxiety, mean (M) = 9.16 (standard deviation [SD] = 4.30); depression, M = 12.80 (SD = 4.27); and stress, M = 21.79 (SD = 4.76). More than one-third (n = 70, 36.1%) experienced two symptoms and 64 (33.0%) reported all three symptoms. Conclusion: Pregnant Black individuals experience high levels of comorbid mental health distress including depression, anxiety, and stress. The findings indicate that treatment for mental health concerns needs to be broad-based and effective for all three conditions. Prenatal interventions should aim to address mental health distress through screening and treatment of depression, anxiety, and stress, especially for pregnant Black individuals. This study furthers understanding of the prevalence of prenatal mental health conditions in pregnant Black people.

show abstract

“…To the best of our knowledge, no intervention study has been conducted on the effectiveness of mHealth consultation services in preventing PPD [ 30 , 31 ]. A recent review has called for a large randomized controlled trial investigating mHealth interventions among perinatal women [ 32 ]. We hypothesized that providing mHealth services offering free and unlimited opportunities for consultation with maternity and childcare professionals would have positive effects on maternal mental health by reducing the aforementioned healthcare access barriers, resolving perinatal concerns, and increasing benefits, even in settings where universal face-to-face perinatal mental care is available.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of mHealth consultation services for preventing postpartum depressive symptoms: a randomized clinical trial

Arakawa

Haseda

Inoue

et al. 2023

BMC Med

View full text Add to dashboard Cite

Background Although many conventional healthcare services to prevent postpartum depression are provided face-to-face, physical and psychosocial barriers remain. These barriers may be overcome by using mobile health services (mHealth). To examine the effectiveness of mHealth professional consultation services in preventing postpartum depressive symptoms in real-world settings, we conducted this randomized controlled trial in Japan, where universal free face-to-face perinatal care is available. Methods This study included 734 pregnant women living in Yokohama city who could communicate in Japanese, recruited at public offices and childcare support facilities. The participants were randomized to the mHealth group (intervention, n = 365), where they could use a free app-based mHealth consultation service with gynecologists/obstetricians, pediatricians, and midwives whenever and as many times as they wanted between 6 p.m. and 10 p.m. on weekdays throughout their pregnancy and postpartum periods (funded by the City of Yokohama government) or the usual care group (control, n = 369). The primary outcome was the risk of elevated postpartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale score ≥ 9. Secondary outcomes were self-efficacy, loneliness, perceived barriers to healthcare access, number of clinic visits, and ambulance usage. All outcomes were collected three months post-delivery. We also conducted subgroup analyses assessing the differences in the treatment effect by sociodemographic status. Results Most women completed all questionnaires (n = 639 of 734, response rate: 87%). The mean baseline age was 32.9 ± 4.2 years, and 62% were primipara. Three months post-delivery, women in the mHealth group had a lower risk of elevated postpartum depressive symptoms (47/310 [15.2%]) compared to the usual care group (75/329 [22.8%], risk ratio: 0.67 [95% confidence interval: 0.48–0.93]). Compared with the usual care group, women in the mHealth group had higher self-efficacy, less loneliness, and fewer perceived barriers to healthcare access. No differences were observed in the frequency of clinic visits or ambulance usage. Furthermore, in the subgroup analyses, we did not find differences in the treatment effect by sociodemographic status. Conclusions Local government-funded mHealth consultation services have a preventive effect on postpartum depressive symptoms, removing physical and psychological barriers to healthcare access in real-world settings. Trial registration UMIN-CTR identifier: UMIN000041611. Registered 31 August 2021.

show abstract

Scaling up Mental Healthcare for Perinatal Populations: Is Telemedicine the Answer?

Cited by 8 publications

References 56 publications

Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

Depression, anxiety, and stress in pregnant Black people

Effectiveness of mHealth consultation services for preventing postpartum depressive symptoms: a randomized clinical trial

Contact Info

Product

Resources

About