Guille Constance, Henrich Natalie, Brinson Alison K, Jahnke Hannah R
Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston South Carolina USA.
Department of Obstetrics and Gynecology Medical University of South Carolina Charleston South Carolina USA.
Psychiatr Res Clin Pract. 2023 Nov 29;6(1):23-32. doi: 10.1176/appi.prcp.20230035. eCollection 2024 Spring.
Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among peripartum people with a history of mental health disorders and determine which components of utilization associate with maternal mental health outcomes.
Participants in this retrospective cohort analysis ( = 1561) accessed Maven as an employer-sponsored health benefit and enrolled during their pregnancy and delivered from January 2020 through September 2022. Participants completed health surveys at enrollment, including history of a mood disorder, and post-delivery. Maven includes online articles, asynchronous and synchronous virtual classes, app-based mental health screenings, access to allied health professional and maternity care providers via messaging and telehealth appointments. Quantile g-computation was used to estimate the effects of multi-utilization exposures on reports of postpartum depression (PPD) and management of mental health.
Multi-utilization exposure mixture models demonstrated that increasing use of digital resources by one quartile is associated with an increased odds of reporting that Maven helped users manage their mental health (aOR: 12.58 [95% CI: 6.74, 23.48]) and was not associated with self-reported incidence of PPD (aOR: 1.30 [95% CI: 0.52, 3.27]). Care advocate appointments, provider messages, and article reads were positively associated with improved mental health management.
Digital health platforms, such as Maven, may play an important role in managing maternal mental health conditions among pregnant and postpartum people at high risk for PPD.
数字健康解决方案有改善孕产妇心理健康护理的潜力。本研究的目的是确定使用数字健康平台Maven是否与改善有心理健康障碍病史的围产期人群的心理健康管理相关，并确定使用的哪些组成部分与孕产妇心理健康结果相关。
这项回顾性队列分析的参与者（n = 1561）将Maven作为雇主提供的健康福利来使用，并在孕期注册，于2020年1月至2022年9月期间分娩。参与者在注册时完成了健康调查，包括情绪障碍病史，并在产后再次进行调查。Maven包括在线文章、异步和同步虚拟课程、基于应用程序的心理健康筛查、通过消息传递和远程医疗预约联系联合健康专业人员和产科护理提供者。分位数g计算用于估计多种使用暴露对产后抑郁症（PPD）报告和心理健康管理的影响。
多种使用暴露混合模型表明，数字资源使用量增加四分之一与报告Maven帮助用户管理心理健康的几率增加相关（调整后比值比：12.58 [95%置信区间：6.74, 23.48]），且与自我报告的PPD发病率无关（调整后比值比：1.30 [95%置信区间：0.52, 3.27]）。护理倡导者预约、与提供者的消息交流和文章阅读与改善心理健康管理呈正相关。
数字健康平台，如Maven，可能在管理有PPD高风险的孕妇和产后人群的孕产妇心理健康状况方面发挥重要作用。
