Objectives

Traditional mindfulness-based interventions have been shown to reduce depression symptoms in pregnant women, although in-person classes may pose significant accessibility barriers, particularly during the COVID-19 pandemic. Mobile technology offers greater convenience, but little is known regarding the efficacy of self-paced, mobile-delivered (mHealth) mindfulness interventions in this population. This study tested the feasibility and acceptability of offering such an intervention for pregnant women with moderate-to-moderately-severe depression symptoms.

Methods

We conducted a single-arm trial within Kaiser Permanente Northern California (KPNC). Participants were identified through KPNC’s universal perinatal depression screening program. Eligible participants included English-speaking pregnant women (<28 weeks of gestation) with moderate-to-moderately-severe depressive symptoms without a regular (<3 times/week) mindfulness/meditation practice. Participants were asked to follow a self-paced, 6-week mindfulness meditation program using a mobile app, Headspace™, 10–20 min/day. Outcome measures included feasibility, acceptability, and patient-reported outcomes (e.g., depression symptoms).

Results

Of the 27 women enrolled, 20 (74%) completed the study. Over half (55%) of participants used the app ≥50% of the days during the 6-week intervention. Responses to the semi-structured interviews indicated that women appreciated the convenience of the intervention and the ability to engage without having to attend classes or arrange childcare. We observed significant improvements in pre-postintervention scores for depression symptoms, perceived stress, sleep disturbance, and mindfulness.

Conclusions

Our study demonstrates the feasibility and acceptability of an mHealth mindfulness intervention for women with moderate-to-moderately-severe antenatal depression symptoms. The preliminary data further suggest that an efficacy trial is warranted.

中文翻译：

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中度至中度重度产前抑郁症状女性的 mHealth 正念干预：综合医疗保健系统内的试点研究

目标

传统的基于正念的干预措施已被证明可以减少孕妇的抑郁症状，尽管面对面课程可能会造成重大的无障碍障碍，尤其是在 COVID-19 大流行期间。移动技术提供了更大的便利，但对于自定进度、移动交付 (mHealth) 正念干预在该人群中的效果知之甚少。本研究测试了为患有中度至中度严重抑郁症状的孕妇提供此类干预的可行性和可接受性。

方法

我们在北加州凯撒医疗机构 (KPNC) 内进行了一项单臂试验。参与者是通过 KPNC 的通用围产期抑郁症筛查计划确定的。符合条件的参与者包括讲英语的孕妇（<28 孕周），没有定期（<3 次/周）正念/冥想练习的中度至中度重度抑郁症状。参与者被要求使用移动应用程序 Headspace™ 进行为期 6 周的自定进度正念冥想计划，每天 10-20 分钟。结果测量包括可行性、可接受性和患者报告的结果（例如，抑郁症状）。

结果

在参加的 27 名女性中，20 名（74%）完成了研究。在为期 6 周的干预期间，超过一半 (55%) 的参与者使用该应用程序的时间≥50%。对半结构化访谈的回应表明，女性赞赏干预的便利性以及无需上课或安排托儿就可以参与的能力。我们观察到抑郁症状、感知压力、睡眠障碍和正念的干预前评分有显着改善。

结论

我们的研究证明了对有中度至中度产前抑郁症状的女性进行 mHealth 正念干预的可行性和可接受性。初步数据进一步表明有必要进行疗效试验。