Health-Tech Reports / August 15, 2016

Web-Based and Mobile Interventions for Prenatal and Postnatal Women

by  Leona Tan

Overall Summary:

This aim of this study was to review the evidence for digital and mobile prenatal and postnatal health interventions. PSYCinfo and Medline databases were searched on March 31st 2016. The search was limited to research studies dating back to 2000. Studies that did not have a health or mental health outcome were excluded from the review.

A total of 27 studies examining digital, mobile, and telephone health interventions for prenatal and postnatal women were found. An almost equal number of studies were found for prenatal (n=14) and postnatal (n=13) interventions. Majority (n=18) of studies concerned symptomatic individuals with a health or mental health issue, while the remaining studies (n=8) were from a healthy population. Only one study examined participants currently in treatment for drug use. Participants from most of these studies (n=11) were from a low socio-economic (SES) background. The remaining studies reported participants from either a mixed SES or did not collect SES data (n=8 respectively).

Given the variety of interventions and heterogeneity of study characteristics, it was difficult to make direct comparisons between studies to assess the strength of evidence and study quality for each type of intervention. Thus, meaningful comparisons on the various interventions could not be determined, and results should be interpreted cautiously.

Nevertheless, certain overall impressions were clear, such as the use of internet-based CBT being the most common intervention identified. This is unsurprising given the breadth of historical evidence for CBT from face-to-face intervention studies. Only one of the 27 identified studies examined the use of a smartphone application. This randomized controlled trial (RCT) investigated the use of a multiple session tracking application on physical activity but did not find a significant change between the intervention or control groups.

Majority of prenatal interventions examined smoking abstinence as an outcome while depression was the most commonly investigated outcome for postnatal studies. RCTs were the most common (78%) form of study design for both prenatal and postnatal interventions, with only six studies varying from this design.

Prenatal intervention studies (n=14)

  • Majority of prenatal studies were either online CBT based interventions or a single-session computer delivered brief motivation intervention (n=4 respectively). This was followed by multiple session mobile tracking, text messaging, and telephone counselling and (n=2 respectively). A final study examined the effect of an educational website for placenta complications and maternal anxiety.
  • Most prenatal intervention studies (n=7) examined smoking abstinence as an outcome, followed by alcohol (n=5), healthy pregnancy and nutrition (n=3 respectively), depression and physical activity (n=2 for each of these outcomes). Only one study examined anxiety as an outcome and the final study examined the effect of the prenatal intervention on weight loss.
  • The majority of these studies did not produce significant findings or found mixed results, that is, significant changes in some symptoms but not in others. Five studies reported significant results, three of which were internet based CBT interventions. The study outcomes for this type of intervention were alcohol use, depression, and smoking, respectively. One study found significant results for an educational website (“Placenta Clinic”) of reducing anxiety symptoms, and the final study found that telephone counselling was able to significantly reducing smoking in pregnant women.

Postnatal intervention studies (n=13)

  • Online CBT was the most common form (n=6) of intervention identified in postnatal intervention studies, followed by a single-session computer delivered brief motivation intervention (n=4). The remaining interventions were single studies on multiple session mobile tracking, an educational website and telephone counselling.
  • Most postnatal intervention studies (n=7) examined depression as an outcome, followed by anxiety (n=4) and drug use (n=3), prolonged grief, posttraumatic stress, weight loss (n=2 for each outcome). Only one study examined alcohol use as an outcome, and one other study examined the impact of the intervention on nutrition uptake.
  • The majority of postnatal intervention studies did not produce significant findings or found mixed results. Five studies reported significant results, four of which were internet based CBT interventions. The remaining study was a multiple session mobile tracking intervention. All of these studies varied in term of outcomes measured.

Read the full report here>>>



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