Skip to main content

Advertisement

Log in

Theory-driven development of a mobile phone supported intervention for adolescents with perinatal depression

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria.

Methods

We conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains.

Results

FGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, “as need arises” phone calls, and the involvement of "neighborhood mothers”. In the inner settings, care providers’ behaviour is addressed with training to increase their capacity to engage young mothers in treatment.

Conclusion

A theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ekefre EN, Ekanem SA, Esien OEE (2014) Teenage pregnancy and education in Nigeria: a philo-sociological management strategy. J Educ Soc Res 4(3):41

    Google Scholar 

  2. Wardlaw T et al (2014) UNICEF report: enormous progress in child survival but greater focus on newborns urgently needed. Reprod Health 11(1):1–4

    Article  Google Scholar 

  3. Gureje O et al (2019) High- versus low-intensity interventions for perinatal depression delivered by non-specialist primary maternal care providers in Nigeria: cluster randomised controlled trial (the EXPONATE trial). Br J Psychiatry 215(3):528–535

    Article  PubMed  Google Scholar 

  4. Dinwiddie KJ, Schillerstrom TL, Schillerstrom JE (2018) Postpartum depression in adolescent mothers. J Psychosom Obstet Gynaecol 39(3):168–175

    Article  PubMed  Google Scholar 

  5. Siegel RS, Brandon AR (2014) Adolescents, pregnancy, and mental health. J Pediatr Adolesc Gynecol 27(3):138–150

    Article  PubMed  Google Scholar 

  6. World Health Organization (2010) Mental Health Gap Action Programme: MhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: version 1.0. World Health Organization, pp 86–94

  7. Keynejad RC et al (2018) WHO mental health gap action programme (mhGAP) intervention guide: a systematic review of evidence from low and middle-income countries. Evid Based Ment Health 21(1):30–34

    Article  PubMed  Google Scholar 

  8. Rahman A (2007) Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan—A multi-method study. Arch Womens Ment Health 10(5):211–219

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hatzenbuehler ML, Phelan JC, Link BG (2013) Stigma as a fundamental cause of population health inequalities. Am J Public Health 103(5):813–821

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kola L et al (2020) Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria. BMC Pregnancy Childbirth 20:1–8

    Article  Google Scholar 

  11. Naslund JA et al (2017) Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature. Lancet Psychiatry 4(6):486–500

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kola L (2019) Making a case for use of digital interventions to manage adolescent perinatal depression in Nigeria. Biomed Sci Res 6(4)

  13. Kruse C et al (2019) Barriers to the use of mobile health in improving health outcomes in developing countries: systematic review. J Med Internet Res 21(10):e13263

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yang Q, Van Stee SK (2019) The comparative effectiveness of mobile phone interventions in improving health outcomes: meta-analytic review. JMIR mHealth uHealth 7(4):e11244

    Article  PubMed  PubMed Central  Google Scholar 

  15. Akinfaderin-Agarau F et al (2012) Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian states. Afr J Reprod Health 16(2):219–230

    PubMed  Google Scholar 

  16. Oyeyemi SO, Wynn R (2014) Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case–control study of a Nigerian project. Reprod Health 11(1):8

    Article  PubMed  PubMed Central  Google Scholar 

  17. Colaci D, Chaudhri S, Vasan A (2016) mHealth interventions in low-income countries to address maternal health: a systematic review. Ann Glob Health 82(5):922–935

    Article  PubMed  Google Scholar 

  18. Kola L et al (2021) Mobile phone use and acceptability for the delivery of mental health information among perinatal adolescents in Nigeria: survey study. JMIR Mental Health 8(1):e20314

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fedele DA et al (2017) Mobile health interventions for improving health outcomes in youth: a meta-analysis. JAMA Pediatr 171(5):461–469

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nilsen P (2020) Making sense of implementation theories, models, and frameworks. In: Implementation Science 3.0. Springer, New York, pp 53–79

  21. Cane J, O’Connor D, Michie S (2012) Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 7(1):37

    Article  PubMed  PubMed Central  Google Scholar 

  22. Michie S, Van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6(1):42

    Article  PubMed  PubMed Central  Google Scholar 

  23. Means AR et al (2020) Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low-and middle-income countries: a systematic review. Implement Sci 15(1):1–19

    Article  Google Scholar 

  24. Gureje O et al (2015) Expanding care for perinatal women with depression (EXPONATE): study protocol for a randomized controlled trial of an intervention package for perinatal depression in primary care. BMC Psychiatry 15:136

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Krueger RA, Casey MA (2002) Designing and conducting focus group interviews. St Paul, Minnesota, USA

    Google Scholar 

  26. Srivastava P, Hopwood N (2009) A practical iterative framework for qualitative data analysis. Int J Qual Methods 8(1):76–84

    Article  Google Scholar 

  27. Mayring P (2000) Pensionierung als Krise oder Glücksgewinn?—Ergebnisse aus einer quantitativ-qualitativen Längsschnittuntersuchung. Z Gerontol Geriatr 33(2):124–133

    Article  CAS  PubMed  Google Scholar 

  28. Kondracki NL, Wellman NS, Amundson DR (2002) Content analysis: Review of methods and their applications in nutrition education. J Nutr Educ Behav 34(4):224–230

    Article  PubMed  Google Scholar 

  29. Griffiths KM et al (2011) Seeking help for depression from family and friends: a qualitative analysis of perceived advantages and disadvantages. BMC Psychiatry 11(1):196

    Article  PubMed  PubMed Central  Google Scholar 

  30. Elayyan M, Rankin J, Chaarani M (2018) Factors affecting empathetic patient care behaviour among medical doctors and nurses: an integrative literature review. East Mediterr Health J 24(3):311–318

    Article  PubMed  Google Scholar 

  31. Hagen P et al (2012) Participatory Design of evidence-based online youth mental health promotion, intervention and treatment. http://pandora.nla.gov.au/pan/141862/20160405-1343/www.youngandwellcrc.org.au/wp-content/uploads/2014/03/Young_and_Well_CRC_IM_PD_Guide.pdf.

  32. Damschroder LJ et al (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 4:50

    Article  PubMed  PubMed Central  Google Scholar 

  33. Riley WT et al (2011) Health behavior models in the age of mobile interventions: are our theories up to the task? Transl Behav Med 1(1):53–71

    Article  PubMed  PubMed Central  Google Scholar 

  34. Greenspun H, Coughlin S (2012) mHealth in an mWorld: how mobile technology is transforming health care. Deloitte Center for Health Solutions, London, pp 1–21

    Google Scholar 

  35. Comulada WS et al (2019) Using mHealth to deliver a home-based testing and counseling program to improve linkage to care and ART adherence in rural South Africa. Prev Sci 20(1):126–136

    Article  PubMed  PubMed Central  Google Scholar 

  36. Braun R et al (2013) Community health workers and mobile technology: a systematic review of the literature. PLoS ONE 8(6):e65772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Tursi MFS et al (2013) Effectiveness of psychoeducation for depression: a systematic review. Austr N Z J Psychiatry 47(11):1019–1031

    Article  Google Scholar 

  38. Hoeft TJ et al (2018) Task-sharing approaches to improve mental health care in rural and other low-resource settings: a systematic review. J Rural Health 34(1):48–62

    Article  PubMed  Google Scholar 

  39. Weinstein J (2010) Mental health, service user involvement and recovery. Jessica Kingsley Publishers, London

    Google Scholar 

  40. Brand G, Morrison P, Down B (2014) How do health professionals support pregnant and young mothers in the community? A selective review of the research literature. Women Birth 27(3):174–178

    Article  PubMed  Google Scholar 

  41. Lukens EP, McFarlane WR (2004) Psychoeducation as evidence-based practice: considerations for practice, research, and policy. Brief Treatment Crisis Interv 4(3):205–225

    Article  Google Scholar 

  42. Howard M et al (2019) Primary care clinicians’ confidence, willingness participation and perceptions of roles in advance care planning discussions with patients: a multi-site survey. Fam Pract 37(2):219–226

    Google Scholar 

  43. Shorey S et al (2015) A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas. J Adv Nurs 71(6):1260–1273

    Article  PubMed  Google Scholar 

  44. Mildon A, Sellen D (2019) Use of mobile phones for behavior change communication to improve maternal, newborn and child health: a scoping review. J Glob Health 9(2):020425

    Article  PubMed  PubMed Central  Google Scholar 

  45. Kak N, Burkhalter B, Cooper M-A (2001) Measuring the competence of healthcare providers. Oper Res Issue Pap 2(1):1–28

    Google Scholar 

  46. Van Straten A et al (2010) Stepped care for depression in primary care: what should be offered and how? Med J Aust 192:S36–S39

    PubMed  Google Scholar 

  47. Forman DR et al (2007) Effective treatment for postpartum depression is not sufficient to improve the developing mother–child relationship. Dev Psychopathol 19(2):585–602

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by a research grant from Innovating for Maternal and Child Health in Africa/International Development Research Centre Canada (Grant number: 108040-001).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lola Kola.

Ethics declarations

Conflict of interest

All authors have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kola, L., Abiona, D., Oladeji, B.D. et al. Theory-driven development of a mobile phone supported intervention for adolescents with perinatal depression. Soc Psychiatry Psychiatr Epidemiol 57, 1201–1210 (2022). https://doi.org/10.1007/s00127-021-02198-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-021-02198-3

Keywords

Navigation