The IMAGINE social media intervention: Uptake, acceptability, utility and association with mental wellness of perinatal youth

Abstract

Background:Perinatal depression affects thirteen percent of birthing people. This includes any clinically significant depressive symptoms during pregnancy or up to 1 year postpartum. Parenting people of color experience a higher risk of postpartum depression (38%). Those younger than 25 are at a higher risk of perinatal depression than older age groups. Technology-based interventions delivered through the internet, have been shown to be feasible and improve perinatal mental health. Study purpose: The Interactive Maternal Group for Information and Emotional support (IMAGINE) pilot study sought to adapt an existing CBT based program (Mothers and Babies) developed for low-income racial minority birthing youth in the US to be delivered virtually. Methods:IMAGINE was delivered to two groups of participants (n=7, n=3) using the online mobile messaging platform, Slack. A trained facilitator sent graphical, video and text messages to participants 3-4 times per week. Content was designed to promote discussion and reflection, lasted for 10-12 weeks, and primarily asynchronous for smartphone access. Recruitment was from Feb-Dec 2020. Included participants were pregnant or up to 6 weeks postpartum, between ages 16-24. All participants had access to a smartphone, English language literacy, and low depressive symptoms (<10 on PHQ-9). Data were collected on acceptability (by AIM), CBT skill use, and PHQ-9 depression symptom data were collected. Results:This pilot study had high acceptability with an average score of 4.28 out of 5, and 100% of participants noting they would recommend IMAGINE to a friend. Most CBT skills discussed in the intervention were reported to be used by 50% or more of participants. For uptake, a high proportion of eligible participants demonstrated interest but were ineligible due to high depressive symptoms. This study found no significant changes in depression scores, perceived stress, or perceived social support, although the study’s small sample size was not powered to detect symptom changes. Discussion/conclusions:This data gives promise for IMAGINE’s future impact on mental wellness, and appeal to individuals experiencing symptoms of depression, but further trials are needed.