Osweiler Bailey W, Rammaha Thue, Szlyk Hannah S, Dell Nathaniel A, Macon Jushawn, Jacobson Nicholas C, Burley Casey, Goodman Micah, Cavazos-Rehg Patricia A, Ramsey Alex T
McKelvey School of Engineering, Washington University in St. Louis, St. Louis, MO, United States.
School of Medicine, Washington University in St. Louis, St. Louis, MO, United States.
Front Psychiatry. 2025 Sep 1;16:1607652. doi: 10.3389/fpsyt.2025.1607652. eCollection 2025.
Pregnant and postpartum individuals (PPI) face unique challenges to recovery from opioid use disorder (OUD), including stigma from self and others. is a mobile application featuring an ecological momentary intervention to reduce self-stigma and provide support for perinatal individuals with OUD. This study aimed to refine and test using the Discover, Design/Build, and Test (DDBT) framework. We hypothesized that DDBT would be associated with increased intervention acceptability, and would be associated with decreased self-stigma among PPI with OUD.
In this fully-remote study, participants provided human-centered design feedback in semi-structured interviews at 1-month to guide adaptations. Participants also completed structured questionnaires including validated measures of self-stigma at baseline, 1-month, and 2-month follow-ups and technology acceptance at 1-month and 2-month follow-ups. Paired samples t-tests determined whether differences existed between baseline and 2-month self-stigma and between 1-month and 2-month technology acceptance.
Twenty PPI (40% pregnant, 60% postpartum) representing diverse geographic U.S. regions used . Qualitative findings highlighted the value of peer support and positive framing but revealed modifiable barriers and a desire for additional features. Human-centered design feedback guided adaptations, including added discussion group features and enhanced relevance of messages. Quantitatively, self-stigma decreased from baseline (M=2.70, SD=0.47) to 2-month (M=2.27, SD=0.61), t(19)=-2.902, p=0.009 (Cohen's d=0.742). Technology acceptance was high at 1-month and increased by 2-month, t(15)=3.211, p=0.006.
These results support the potential of digital interventions to reduce self-stigma and improve perinatal OUD recovery outcomes. The DDBT framework provides structure to understand lived experiences, adapt rapidly, and evaluate digital intervention efficacy.
怀孕及产后人群（PPI）在从阿片类物质使用障碍（OUD）中恢复时面临独特挑战，包括来自自身及他人的耻辱感。[应用名称]是一款移动应用程序，具有生态瞬时干预功能，可减少自我耻辱感，并为患有OUD的围产期人群提供支持。本研究旨在使用发现、设计/构建和测试（DDBT）框架对[应用名称]进行优化和测试。我们假设DDBT将与干预可接受性的提高相关联，并且[应用名称]将与患有OUD的PPI的自我耻辱感降低相关联。
在这项完全远程的研究中，参与者在1个月时通过半结构化访谈提供以用户为中心的设计反馈，以指导调整。参与者还完成了结构化问卷，包括在基线、1个月和2个月随访时对自我耻辱感的有效测量，以及在1个月和2个月随访时对技术接受度的测量。配对样本t检验确定基线和2个月时自我耻辱感之间以及1个月和2个月时技术接受度之间是否存在差异。
20名代表美国不同地理区域的PPI（40%为孕妇，60%为产后）使用了[应用名称]。定性研究结果突出了同伴支持和积极框架的价值，但也揭示了可修改的障碍以及对额外功能的需求。以用户为中心的设计反馈指导了调整，包括添加讨论组功能和增强信息的相关性。在定量方面，自我耻辱感从基线时（M = 2.70，SD = 0.47）降至2个月时（M = 2.27，SD = 0.61），t(19) = -2.902，p = 0.009（科恩d值 = 0.742）。技术接受度在1个月时较高，并在2个月时有所提高，t(15) = 3.211，p = 0.006。
这些结果支持数字干预在减少自我耻辱感和改善围产期OUD恢复结果方面的潜力。DDBT框架为理解生活经历、快速调整和评估数字干预效果提供了结构。
