(544) Mixed Method Approach to Understanding Participation Barriers in a Perinatal Depression Group Telehealth Intervention Trial

Group telehealth interventions (GTI) may reduce perinatal depressive and anxiety (PDA) symptom burden among peripartum individuals. However, study participation for this population may be challenging. The objective of this study was to use a mixed methods approach to understand themes associated with completion of planned interventions in randomized controlled trial (RCT) assessing GTI efficacy on PDA.


Study Design:

Secondary analysis of RCT of mindfulness-based and cognitive behavioral therapy approach compared to attention control group (10 sessions in each arm over six months) (NCT03932760). We consented and enrolled peripartum (pregnant and 6 months postpartum) individuals > 18 years old with mild to moderate depression symptoms (defined as Edinburgh Postpartum Depression Scale > 9) from the electronic medical record.  We compared participant characteristics, survey results and open-ended question between those who did and did not complete planned interventions. Qualitative results were coded and analyzed for themes on acceptance and barriers to RCT intervention participation. Focus group transcripts among those who completed interventions were coded and analyzed for similar themes.

Results:

Of 81 consented individuals, 44 (54.3%) did not complete and 37 (45.7%) completed six months of planned interventions. Individuals who did not complete study interventions were younger, more frequently postpartum and single compared to those who did complete study interventions (Table). At baseline, both groups identified similar initial barriers of RCT participation as fear of disclosure of PDA to others, lack of time or interest, and minimization of PDA symptom burden. Among those who completed interventions, participants reported that their initial concerns were mitigated by validation of their symptoms, connection within their intervention groups, and acceptance by diverse community with similar experiences. 

 

Conclusion: Though GTI may be feasible, significant barriers to recruitment and retention in an RCT exist precluding the assessment of efficacy of these intervention among peripartum women with PDA.