14-23% of pregnancies are impacted by symptoms of depression.
Depression symptoms can increase women’s risk behaviors during pregnancy, such as poor nutrition and substance and alcohol use, leading to premature birth, low birth weight, and development problems. At the start of this project, there was little systematic screening for depression among prenatal patients at the Helen O. Dickens Center for Women, and limited communication between visits with women experiencing symptoms.
While staff at the Dickens Center reported difficulty reaching patients on the phone, we observed that patients were avid users of text messaging.
Our team worked closely with the Dickens Center and Obstetrical Services to develop a mobile screening application for prenatal depression. We then piloted a text-based mood-monitoring program, engaging patients at the Center to participate.
The screening intervention increased the rate of standardized screening for prenatal depression from virtually 0% to 70%, with all patients using the same evidence-based tool with results uploaded directly and immediately to a clinical information system for provider reference and translated from raw scores into a preliminary diagnostic and treatment plan.
During a small, rapid validation pilot, four enrolled patients sent in 80% of mood scores requested and two engaged heavily in the intervention as a way to communicate in more detail with mental health providers between visits. Subsequently, we partnered with Ginger.io to conduct a clinical trial of remote monitoring of depression in the prenatal period.