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Pregnant Women's Views on the Feasibility and Acceptability of Web-Based Mental Health E-Screening Versus Paper-Based Screening: A Randomized Controlled Trial.
- Source :
- Journal of Medical Internet Research; Apr2017, Vol. 19 Issue 4, p1-1, 1p, 1 Color Photograph, 4 Charts
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Major international guidelines recommend mental health screening during the perinatal period. However, substantial barriers to screening have been reported by pregnant and postpartum women and perinatal care providers. E-screening offers benefits that may address implementation challenges.<bold>Objective: </bold>The primary objective of this randomized controlled trial was to evaluate the feasibility and acceptability of Web-based mental health e-screening compared with paper-based screening among pregnant women. A secondary objective was to identify factors associated with women's preferences for e-screening and disclosure of mental health concerns.<bold>Methods: </bold>Pregnant women recruited from community and hospital-based antenatal clinics and hospital-based prenatal classes were computer-randomized to a fully automated Web-based e-screening intervention group or a paper-based control group. Women were eligible if they spoke or read English, were willing to be randomized to e-screening, and were willing to participate in a follow-up diagnostic interview. The intervention group completed the Antenatal Psychosocial Health Assessment and the Edinburgh Postnatal Depression Scale on a tablet computer, while controls completed them on paper. All women completed self-report baseline questions and were telephoned 1 week after randomization by a blinded research assistant for a MINI International Neuropsychiatric Interview. Renker and Tonkin's tool of feasibility and acceptability of computerized screening was used to assess the feasibility and acceptability of e-screening compared with paper-based screening. Intention-to-treat analysis was used. To identify factors associated with preference for e-screening and disclosure, variables associated with each outcome at P<.20 were simultaneously entered into final multivariable models to estimate adjusted odds ratios (AORs) and 95% CIs.<bold>Results: </bold>Of the 675 eligible women approached, 636 agreed to participate (participation rate 94.2%) and were randomized to the intervention (n=305) or control (n=331) groups. There were no significant baseline differences between groups. More women in the e-screening group strongly or somewhat agreed that they would like to use a tablet for answering questions on emotional health (57.9%, 175/302 vs 37.2%, 121/325) and would prefer using a tablet to paper (46.0%, 139/302 vs 29.2%, 95/325), compared with women in the paper-based screening group. There were no differences between groups in women's disclosure of emotional health concerns (94.1%, 284/302 vs 90.2%, 293/325). Women in the e-screening group consistently reported the features of e-screening more favorably than controls (more private or confidential, less impersonal, less time-consuming). In the multivariable models, being in the e-screening group was significantly associated with preferring e-screening (AOR 2.29, 95% CI 1.66-3.17), while no factors were significantly associated with disclosure.<bold>Conclusions: </bold>The findings suggest that mental health e-screening is feasible and acceptable to pregnant women.<bold>Trial Registration: </bold>Clinicaltrials.gov NCT01899534; https://clinicaltrials.gov/ct2/show/NCT01899534 (Archived by WebCite at http://www.webcitation.org/6ntWg1yWb). [ABSTRACT FROM AUTHOR]
- Subjects :
- PREGNANT women
RANDOMIZED controlled trials
MENTAL depression
AFFECTIVE disorders
WOMEN'S mental health
ANXIETY diagnosis
DIAGNOSIS of mental depression
PREGNANCY complications
COMPARATIVE studies
INDUSTRIES
INTERNET
RESEARCH methodology
MEDICAL cooperation
MEDICAL screening
MENTAL health
RESEARCH
STATISTICAL sampling
TELEMEDICINE
PILOT projects
EVALUATION research
EDINBURGH Postnatal Depression Scale
PATIENTS' attitudes
PSYCHOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 14394456
- Volume :
- 19
- Issue :
- 4
- Database :
- Supplemental Index
- Journal :
- Journal of Medical Internet Research
- Publication Type :
- Academic Journal
- Accession number :
- 122829857
- Full Text :
- https://doi.org/10.2196/jmir.6866