Walk with Me (WWM) for Perinatal Grief

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Project Summary The loss of a child during pregnancy and the early postpartum period causes significant psychological distress for many women and their partners and may lead to long-lasting psychological impairment and disorder such as posttraumatic stress, prolonged grief, and suicide. Approximately 24,000 babies in the United States are stillborn each year and over 14,000 infants die within the first 30 days of life. About 15% of parents will experience a miscarriage and more than 30% of women who experience a miscarriage meet the diagnostic criteria for posttraumatic stress disorder. Currently, there are limited efficacious and accessible treatments to attenuate the effects of trauma and intense grief that are common to perinatal loss. Prior research has found online cognitive behavioral therapy (CBT) to be effective for reducing perinatal grief and post-traumatic stress disorder symptoms. However, there is a need for programs that provide support beyond cognitive reappraisal to offer concrete strategies to reduce distress and increase availability for attachment to subsequent pregnancies including mindfulness practice and the inclusion of guiding principles for working with parents who have experienced perinatal loss. Using guiding principles of grief and infusing practical strategies to reduce distress for bereaved parents such as facilitating partner engagement and examples of grief rituals are be important additions to components of cognitive behavioral therapy for this population. Additionally, bereaved parents may experience damaging communication from health care professionals (HCPs) who lack sufficient training. There are no readily available tools that blend HCP training with direct support for bereaved parents. The goal of this phase I project is to create a prototype of a mobile application that demonstrates promise of effectiveness for reducing parent distress (traumatic stress and intensity of grief) following a perinatal loss. We will accomplish this goal by accomplishing our three specific aims: Specific Aim 1: Use an iterative formative development process to develop training and modules for grief processing and healing activities leveraging cognitive behavioral therapy and guiding principles for working with parents who have experienced perinatal loss. Specific Aim 2: Develop prototype featuring core components of the application. Specifically, HCP training and four key modules for bereaved parents including two on normalization of grief, one on mindfulness to facilitate coping with trauma and distress symptoms and one using CBT strategies to manage negative thoughts. Specific Aim 3: Evaluate the acceptability, usability, and effectiveness of Walk with Me by conducting a mixed-methods program evaluation with HCPs and bereaved parents to optimize the successful use of Walk with Me.