McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA.
Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
BMC Pregnancy Childbirth. 2023 Jun 3;23(1):411. doi: 10.1186/s12884-023-05729-9.
Peripartum Depression (PPD) affects approximately 10-15% of perinatal women in the U.S., with those of low socioeconomic status (low-SES) more likely to develop symptoms. Multilevel treatment barriers including social stigma and not having appropriate access to mental health resources have played a major role in PPD-related disparities. Emerging advances in digital technologies and analytics provide opportunities to identify and address access barriers, knowledge gaps, and engagement issues. However, most market solutions for PPD prevention and management are produced generically without considering the specialized needs of low-SES populations. In this study, we examine and portray the information and technology needs of low-SES women by considering their unique perspectives and providers' current experiences. We supplement our understanding of women's needs by harvesting online social discourse in PPD-related forums, which we identify as valuable information resources among these populations.
We conducted (a) 2 focus groups (n = 9), (b) semi-structured interviews with care providers (n = 9) and low SES women (n = 10), and (c) secondary analysis of online messages (n = 1,424). Qualitative data were inductively analyzed using a grounded theory approach.
A total of 134 open concepts resulted from patient interviews, 185 from provider interviews, and 106 from focus groups. These revealed six core themes for PPD management, including "Use of Technology/Features", "Access to Care", and "Pregnancy Education". Our social media analysis revealed six PPD topics of importance in online messages, including "Physical and Mental Health" (n = 725 messages), and "Social Support" (n = 674).
Our data triangulation allowed us to analyze PPD information and technology needs at different levels of granularity. Differences between patients and providers included a focus from providers on needing better support from administrative staff, as well as better PPD clinical decision support. Our results can inform future research and development efforts to address PPD health disparities.
围产期抑郁症（PPD）在美国影响着大约 10-15%的围产期女性，社会经济地位较低（SES 较低）的女性更有可能出现症状。多层次的治疗障碍，包括社会耻辱和无法获得适当的心理健康资源，在 PPD 相关差异中起了主要作用。数字技术和分析的新进展为识别和解决获取障碍、知识差距和参与问题提供了机会。然而，大多数用于预防和管理 PPD 的市场解决方案都是通用的，没有考虑到 SES 较低人群的特殊需求。在这项研究中，我们通过考虑女性的独特观点和提供者的当前经验来研究和描绘 SES 较低女性的信息和技术需求。我们通过在 PPD 相关论坛中采集在线社交话语来补充我们对女性需求的理解，我们认为这些论坛是这些人群中的有价值的信息资源。
我们进行了（a）2 次焦点小组（n=9），（b）半结构化访谈与护理提供者（n=9）和 SES 较低女性（n=10），以及（c）在线消息的二次分析（n=1424）。使用扎根理论方法对定性数据进行归纳分析。
从患者访谈中产生了 134 个开放概念，从提供者访谈中产生了 185 个，从焦点小组中产生了 106 个。这些揭示了 PPD 管理的六个核心主题，包括“技术/功能的使用”、“获取护理”和“妊娠教育”。我们的社交媒体分析揭示了在线消息中六个重要的 PPD 主题，包括“身心健康”（n=725 条消息）和“社会支持”（n=674 条消息）。
我们的数据三角剖分允许我们在不同的粒度级别上分析 PPD 信息和技术需求。患者和提供者之间的差异包括提供者关注需要行政人员更好的支持，以及更好的 PPD 临床决策支持。我们的研究结果可以为解决 PPD 健康差异的未来研究和开发工作提供信息。
