Utilizing a Smartphone Application for Perinatal Depression Screening and Care Linkages: A Cross-Sectional Cohort Study.

Objective

To evaluate the feasibility of a smartphone app in the identification of perinatal depression (PND) symptoms and provision of subsequent follow-up care/service linkages to postpartum participants.

Methods

Recruitment occurred from November 2021 to June 2024 for this cross-sectional study. Postpartum patients delivering a liveborn infant at a quaternary care academic hospital were offered participation if they were ≥18 years old, English-speaking, used a smartphone, and agreed to downloading the study app. Participants were asked to complete at least 1 in-app mental health assessment per week over the 6-week study period; assessments included the Edinburgh Postpartum Depression Scale (EPDS). Participants identified as at risk of PND received a follow-up call from a study nurse. Process and outcome measure analysis was conducted and reported as proportions.

Results

We identified 13.6% (n=202) of participants with actively monitored pregnancies as having symptoms of PND through positive screening on the EPDS, while 115 participants received nurse follow-up due to participant requests or nonresponsiveness to app prompts. These interactions resulted in 475 nurse telephone calls to 317 participants, with some participants receiving multiple calls. Most participants contacted by the study nurses (17.2%, n=254) preferred to continue with in-app monitoring over seeking care in a traditional clinical setting. The prescreening mood item showed a sensitivity of 65.7% and specificity of 92.6% against the EPDS as the reference standard, supporting its role as a triage tool rather than a replacement for validated screening.

Conclusion

The prevalence of probable PND in our cohort is comparable to that observed in US women, demonstrating the app's ability to identify PND in postpartum individuals. Mobile health apps can assist clinicians in identification and management of patients with depression.