Table Info

Table 3.

Focus group data: desired features in the MommaConnect digital health platform

Focus group question prompts	Desired features
What do you think of the content? Is MommaConnect content culturally relevant to you?	Needs more culturally congruent content.
How can the design of MommaConnect help support you in your relationships with family?	Needs the capability of storing information from therapy sessions (e.g., skills discussed in sessions, and assigned homework).
How do you think it can help you with PPD?	Needs mechanisms to track symptoms and progress in therapy. Needs ways to address mental health stigma within the digital healthcare platform.
What do you think of the design of MommaConnect? What do you like/dislike about the wireframes?	Needs functionality to schedule appointments and contact the provider between sessions, contact information for emergent needs, and forums to chat with other mothers experiencing PPD.
How do you think MommaConnect can help you handle challenges with taking care of your baby?	Needs psychoeducation content about PPD and infant development.

PPD: postpartum depression

Declarations

Acknowledgments

The authors acknowledge Yi Cui, MS., Research Associate, Benten Technologies, who adapted Figure 1. from Wright et al. 2006. We also acknowledge the contributions of our participants.

Author contributions

BP, JAH, PAG, KC, TM: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. ME, MM, KA, JS: Writing—original draft, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the IRB approval at Thomas Jefferson University IRB (approval # iRISID-2023-1894).

Consent to participate

Informed consent to participate in the study was obtained from all participants.

Consent to publication

Not applicable.

Availability of data and materials

The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.

Funding

The authors declare funding from the Stratton Grant; Jefferson College of Nursing; ACORN Innovation Grant; Mass Ventures; HHS Racial Equity in Postpartum Care Challenge Phase 1; HHS Racial Equity in Postpartum Care Challenge Phase 2; and SBIR Phase I Omnibus Solicitation of the NIH for Small Business Innovation Research Grant Applications [1 R43 MD018236-01]; Pilgrim Fund Seed Research Funding Program from the College of Nursing and Health Sciences at the University of Massachusetts, Dartmouth, Dartmouth MA, USA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright

References

Azar FE, Solhi M, Darabi F, Rohban A, Abolfathi M, Nejhaddadgar N. Effect of educational intervention based on PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients. Diabetes Metab Syndr. 2018;12:1075–8. [DOI] [PubMed]

Ghaffarifar S, Ghofranipour F, Ahmadi F, Khoshbaten M. Barriers to Effective Doctor-Patient Relationship Based on PRECEDE PROCEED Model. Glob J Health Sci. 2015;7:24–32. [DOI] [PubMed] [PMC]

Symptoms of Depression Among Women [Internet]. [Cited 2024 Apr 30]. Available from: https://www.cdc.gov/reproductivehealth/depression/index.htm

Minkovitz CS, Strobino D, Scharfstein D, Hou W, Miller T, Mistry KB, et al. Maternal depressive symptoms and children’s receipt of health care in the first 3 years of life. Pediatrics. 2005;115:306–14. [DOI] [PubMed]

Austin M, Kildea S, Sullivan E. Maternal mortality and psychiatric morbidity in the perinatal period: challenges and opportunities for prevention in the Australian setting. Med J Aust. 2007;186:364–7. [DOI] [PubMed]

Chung EK, McCollum KF, Elo IT, Lee HJ, Culhane JF. Maternal depressive symptoms and infant health practices among low-income women. Pediatrics. 2004;113:e523–9. [DOI] [PubMed]

Horwitz SM, Briggs-Gowan MJ, Storfer-Isser A, Carter AS. Prevalence, correlates, and persistence of maternal depression. J Womens Health (Larchmt). 2007;16:678–91. [DOI] [PubMed]

Josefsson A, Sydsjö G. A follow-up study of postpartum depressed women: recurrent maternal depressive symptoms and child behavior after four years. Arch Womens Ment Health. 2007;10:141–5. [DOI] [PubMed]

Tronick E, Reck C. Infants of depressed mothers. Harv Rev Psychiatry. 2009;17:147–56. [DOI] [PubMed]

10.

Feldman R, Granat A, Pariente C, Kanety H, Kuint J, Gilboa-Schechtman E. Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity. J Am Acad Child Adolesc Psychiatry. 2009;48:919–27. [DOI] [PubMed]

11.

Feldman R. The development of regulatory functions from birth to 5 years: insights from premature infants. Child Dev. 2009;80:544–61. [DOI] [PubMed]

12.

Field T, Diego M, Hernandez-Reif M. Depressed mothers' infants are less responsive to faces and voices. Infant Behav Dev. 2009;32:239–44. [DOI] [PubMed] [PMC]

13.

Ford-Jones EL, Williams R, Bertrand J. Social paediatrics and early child development: Part 1. Paediatr Child Health. 2008;13:755–8. [DOI] [PubMed] [PMC]

14.

Barry RA, Kochanska G, Philibert RA. G × E interaction in the organization of attachment: mothers’ responsiveness as a moderator of children’s genotypes. J Child Psychol Psychiatry. 2008;49:1313–20. [DOI] [PubMed] [PMC]

15.

Field T. Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev. 2010;33:1–6. [DOI] [PubMed] [PMC]

16.

Goodman S, Gotlib I. Children of Depressed Parents. Washington: American Psychological Association; 2002.

17.

Timmer SG, Ho LKL, Urquiza AJ, Zebell NM, Garcia EFY, Boys D. The effectiveness of parent–child interaction therapy with depressive mothers: the changing relationship as the agent of individual change. Child Psychiatry Hum Dev. 2011;42:406–23. [DOI] [PubMed]

18.

Toth SL, Rogosch FA, Manly JT, Cicchetti D. The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: a randomized preventive trial. J Consult Clin Psychol. 2006;74:1006–16. [DOI] [PubMed]

19.

Bina R. Predictors of postpartum depression service use: A theory-informed, integrative systematic review. Women Birth. 2020;33:e24–32. [DOI] [PubMed]

20.

Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final Data for 2019. Natl Vital Stat Rep. 2021;70:1–51. [PubMed]

21.

Digital divide persists even as Americans with lower incomes make gains in tech adoption [Internet]. Washington: Pew Research Center; c2024 [cited 2024 Apr 30]. Available from: https://www.pewresearch.org/short-reads/2021/06/22/digital-divide-persists-even-as-americans-with-lower-incomes-make-gains-in-tech-adoption/

22.

Nair U, Armfield NR, Chatfield MD, Edirippulige S. The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis. J Telemed Telecare. 2018;24:639–50. [DOI] [PubMed]

23.

Yin J, Nisar A, Waqas A, Guo Y, Qi WL, Wang D, et al. Psychosocial interventions on perinatal depression in China: A systematic review and meta-analysis. J Affect Disord. 2020;271:310–27. [DOI] [PubMed]

24.

Branquinho M, Rodriguez-Muñoz MF, Maia BR, Marques M, Matos M, Osma J, et al. Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses. J Affect Disord. 2021;291:294–306. [DOI] [PubMed]

25.

Cucciniello M, Petracca F, Ciani O, Tarricone R. Development features and study characteristics of mobile health apps in the management of chronic conditions: a systematic review of randomised trials. NPJ Digit Med. 2021;4:144. [DOI] [PubMed] [PMC]

26.

Hicks JL, Boswell MA, Althoff T, Crum AJ, Ku JP, Landay JA, et al. Leveraging Mobile Technology for Public Health Promotion: A Multidisciplinary Perspective. Annu Rev Public Health. 2023;44:131–50. [DOI] [PubMed] [PMC]

27.

Addotey-Delove M, Scott RE, Mars M. Healthcare Workers’ Perspectives of mHealth Adoption Factors in the Developing World: Scoping Review. Int J Environ Res Public Health. 2023;20:1244. [DOI] [PubMed] [PMC]

28.

Green LW, Kreuter MW, Deeds SG, Partridge KB. Health Education Planning: A Diagnostic Approach. 1st ed. Palo Alto, California: Mayfield Publishing; 1980.

29.

Gielen AC, McDonald EM, Gary T L, Bone LR. Using the precede-proceed model to apply health behavior theories. In: K. Glanz, B. K. Rimer, K. Viswanath, editors. Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass; 2008. pp. 407–33.

30.

Green L, Kreuter M. Health promotion planning: An educational and environmental approach. 2nd ed. California: Mayfield Publishing Company; 1991.

31.

Green L, Kreuter M. Health program planning: An educational and ecological approach. 4th ed. New York, NY: McGraw Hill; 2005.

32.

Wright A, McGorry PD, Harris MG, Jorm AF, Pennell K. Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health. 2006;6:215. [DOI] [PubMed] [PMC]

33.

Geller PA, Posmontier B, Horowitz JA, Bonacquisti A, Chiarello LA. Introducing Mother Baby Connections: a model of intensive perinatal mental health outpatient programming. J Behav Med. 2018;41:600–13. [DOI] [PubMed]

34.

Horowitz JA, Posmontier B, Chiarello LA, Geller PA. Introducing mother-baby interaction therapy for mothers with postpartum depression and their infants. Arch Psychiatr Nurs. 2019;33:225–31. [DOI] [PubMed]

35.

Borsci S, Federici S, Lauriola M. On the dimensionality of the System Usability Scale: a test of alternative measurement models. Cogn Process. 2009;10:193–7. [DOI] [PubMed]

36.

Mol M, Schaik Av, Dozeman E, Ruwaard J, Vis C, Ebert DD, et al. Dimensionality of the system usability scale among professionals using internet-based interventions for depression: a confirmatory factor analysis. BMC Psychiatry. 2020;20:218. [DOI] [PubMed] [PMC]

37.

Measuring Usability with the System Usability Scale (SUS) [Internet]. Denver: MeasuringU; c2024 [cited 2024 Apr 30]. Available from: https://measuringu.com/sus/

38.

Wilson K, Bell C, Wilson L, Witteman H. Agile research to complement agile development: a proposal for an mHealth research lifecycle. NPJ Digit Med. 2018;1:46. [DOI] [PubMed] [PMC]

39.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6. [DOI] [PubMed]

40.

Condon JT, Corkindale CJ. The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument. J Reprod Infant Psychol. 1998;16:57–76. [DOI]