Social Media-Based Parenting Program for Women with Postpartum Depressive Symptoms

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Depression symptoms in the postpartum period are common and a major public health concern. The 12-month prevalence of postpartum depression (PPD) has been estimated at 9.3% by the National Epidemiologic Survey on Alcohol and Related Conditions. PPD has been shown to interfere not only with individual functioning but also with effective parenting that places children at risk for numerous maladaptive outcomes into adulthood. Despite the prevalence and long-term consequences of PPD symptoms, there is substantial evidence of the underutilization of mental health service for this population. Service barriers include logistical, personal, and organizational ones, such as lack of knowledge about where to seek treatment, treatment options, insurance, stigma, and doubt about treatment effectiveness. The current funded R61 award aims to determine the effects of a social media-based parenting program on responsive parenting among women with PPD symptoms. All participants receive access to an online depression treatment program and their PPD symptoms are assessed monthly. Currently, 60% of the mothers still have PPD symptoms above cut-off at 3 months post-intervention. The current COVID-19 pandemic has led to widespread public containment and mitigation strategies, designed to decrease the spread of the SARS-CoV-2 virus. These strategies have forced many women with PPD symptoms to shelter in place at home, socially isolate, and limit direct contact with mental health providers. Preliminary data suggests that individuals with mental health disorders are having difficulty accessing services and experiencing worsening mental health symptoms at this time despite the availability of telehealth services. The main objective of this administrative supplement is to adapt an in-person patient navigation intervention to facilitate access to virtual mental health care among low-income women with PPD symptoms. The aims of this supplement are to adapt a patient navigation intervention for virtual use and to assess its feasibility, acceptability, and target engagement. To accomplish these aims, we propose to conduct 10 semi-structured interviews with current participants to understand barriers and facilitators to mental health services and adapt an existing mental health navigation intervention and engagement measure. Following this, we propose to enroll 30 mothers with persistent PPD symptoms using rapid cycle testing to the adapted virtual navigation intervention to assess feasibility, acceptability, and target engagement over a 3-month period. This supplement is responsive to NOT-MH-20-053 in that it seeks to facilitate access to evidence-based telepsychiatry services among vulnerable urban mothers of color with persistent PPD symptoms. Information from this supplement can be used to test the adapted virtual intervention in a future NIMH application.