一项用于常规孕产妇护理中围产期精神障碍普遍预防的个性化移动健康干预措施(电子围产期):一项混合可行性试点试验的方案研究
A personalized mHealth intervention for the universal prevention of perinatal mental disorders in routine maternal care (e-Perinatal): A protocol study for a hybrid feasibility pilot trial.
作者信息
Nieto-Casado Francisco J, Gómez-Gómez Irene, Aznar-Lou Ignacio, Barquero-Jiménez Carlos, Cáceres Isabel, Carretero Stephanie, Company-Córdoba Rosalba, De-Juan-Iglesias Paula, Domínguez-Salas Sara, Gil-Cosano José J, Goossens Lennert, Rodríguez-Domínguez Carmen, Motrico Emma
机构信息
Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Seville, 41018, Spain.
Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, 41013, Spain.
出版信息
Open Res Eur. 2025 Jun 27;5:170. doi: 10.12688/openreseurope.20386.1. eCollection 2025.
INTRODUCTION
The perinatal period is associated with an increased risk of new-onset depression and anxiety in both mothers and their partners. Despite the significant impact of perinatal mental disorders (PMD) on families and healthcare systems, access to mental health services remains limited due to structural barriers. Mobile health (mHealth) interventions offer a scalable and accessible strategy for universal prevention, but few have been integrated into routine maternal care and evaluated in real-world settings.
PROTOCOL
This study presents the protocol for a two-arm, cluster-randomised, hybrid type 1 pilot trial designed to evaluate the feasibility, acceptability, and preliminary effectiveness of the e-Perinatal app, a personalised mHealth innovation for universal PMD prevention. Eight Primary Healthcare Centres in Andalusia, Spain, will be randomised in a 1:1 ratio to the intervention or control arm. The intervention group will receive access to the e-Perinatal app along with specialised training in perinatal mental health for healthcare professionals involved in routine maternal care. The control group will receive routine maternal care along with monthly psychoeducational emails. A total of 96 pregnant or postpartum women (up to five months postpartum) and their partners will be recruited. Primary outcomes are feasibility and acceptability of the e-Perinatal app as a universal preventive intervention integrated within routine maternal care. Secondary outcomes include implementation measures (i.e., adoption, fidelity, and appropriateness) and preliminary effectiveness indicators (i.e., cumulative incidence of perinatal depression and anxiety, changes in symptoms severity, postnatal post-traumatic stress disorder, and subjective well-being). Additional outcomes include other implementation measures (e.g., participants experiences and reasons to dropout), family dynamics, infant development, app usability, and healthcare utilisation. Data will be analysed using mixed methods.
DISCUSSION
This pilot trial will provide key information on the feasibility of integrating a personalised mHealth intervention into routine maternal care, thereby informing the design of a subsequent large-scale trial.
引言
围产期母婴及其伴侣新发抑郁和焦虑的风险会增加。尽管围产期精神障碍(PMD)对家庭和医疗系统有重大影响,但由于结构性障碍,获得心理健康服务的机会仍然有限。移动健康(mHealth)干预为普遍预防提供了一种可扩展且可及的策略,但很少有干预措施被纳入常规孕产妇护理并在现实环境中进行评估。
方案
本研究介绍了一项双臂、整群随机、1型混合试点试验的方案,旨在评估电子围产期应用程序的可行性、可接受性和初步有效性,该应用程序是一种用于普遍预防PMD的个性化mHealth创新。西班牙安达卢西亚的八个初级医疗保健中心将以1:1的比例随机分为干预组或对照组。干预组将可以使用电子围产期应用程序,并为参与常规孕产妇护理的医护人员提供围产期心理健康方面的专业培训。对照组将接受常规孕产妇护理以及每月一次的心理教育电子邮件。总共将招募96名孕妇或产后妇女(产后五个月内)及其伴侣。主要结局是电子围产期应用程序作为常规孕产妇护理中普遍预防干预措施的可行性和可接受性。次要结局包括实施措施(即采用率、保真度和适宜性)和初步有效性指标(即围产期抑郁和焦虑的累积发病率、症状严重程度的变化、产后创伤后应激障碍和主观幸福感)。其他结局包括其他实施措施(例如参与者的经历和退出原因)、家庭动态、婴儿发育、应用程序可用性和医疗保健利用情况。将使用混合方法分析数据。
讨论
这项试点试验将提供关于将个性化mHealth干预纳入常规孕产妇护理可行性的关键信息,从而为后续大规模试验的设计提供依据。