Table 1.
Summary of the study characteristics of the 34 included full-text articles in systematic review
| ID | Author/ Year | Country | Study Population | Sample Size | Setting | Research Objectives & Research Question | Digital Mode & Method & other assessments | Methodological/ Theoretical approach | Data Collection | Data Analysis | Study Duration | Risk of bias |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Bante et al. (2021) | Arba Minch Zuria district, Gamo zone; Southern Ethiopia | Pregnant women | 667 | Community; Public Health; Public University |
To assess Comorbid Anxiety and Depression (CAD) and associated factors among pregnant women Helping to understand the prevalence of comorbid anxiety and depression |
PHQ-9; GAD-7 collected using Open Data Kit (ODK) android application; Women’s Abuse Screening Test (WAST); Household Food Insecurity Access Scale (HFIAS) | Theoretical and practical training approach for data collectors; Community-based Cross-Sectional Study Design | Data collectors were used to collect data from participants via the Open Data Kit (ODK) | Socio-demographic (frequency & percentage) and socioeconomic characteristics; obstetric characteristics (frequency & percentage); prevalence of comorbid anxiety and depression (percentage); factors associated with comorbid anxiety and depression (N, %, OR, p-value, Adjusted Odds Ratios; 95% CI, p-value) | 11 months | Moderate |
| 2 | Barry et al. (2017) | Ireland & England, UK | Pregnant women | 21 | Public Health |
Virtue ethics for mHealth design; Self-report during pregnancy Helping to understand the barriers and enablers of mHealth design |
EPDS-10; EMA; BrightSelf App; self-report | Qualitative | Case Study; Individual design sessions; Group design sessions | Thematic Analysis | 5 Design Sessions | Low/Moderate |
| 3 | Diez-Canseco et al. (2018) | Lima, Peru | Women (Antenatal care service) | 931 | Public Health; Primary Health Care |
Design, develop and test an intervention to promote early detection, referral and access to treatment of patients with mental health issues in public primary health care Helping to understand the feasibility and effectiveness of digital screening |
SRQ (WHO) – 28 questions (Peru version); mHealth screening App | Mixed-Methods | Qualitative and Quantitative data collected concurrently | Quantitative: descriptive analyses, frequencies and percentages; Qualitative: Interviews | 9 weeks (Healthcare Provider Training) | Moderate |
| 4 | Doherty et al. (2020) | London & Cambridge, UK | Women (pregnant & non-pregnant) and Health Professionals | 38 | Public Health |
Clinical interface of a mobile application for the self-report of psychological wellbeing and depression during pregnancy Helping to understand the barriers and enablers of digital screening |
EPDS-10; BrightSelf App; self-report | Qualitative; Tatar’s Design Tensions Framework | Design sessions with women and Health Professionals (one of five large group design sessions or one of 17 individual sessions) | Thematic Analysis | 5 Large group design sessions; 1 of 17 individual design sessions | Low/Moderate |
| 5 | Doherty et al. (2018) | London & Cambridge, UK | Women (pregnant n = 8 & non-pregnant n = 3) and Health Professionals (n = 27) | 38 | Public Health |
To explore the issues and challenges surrounding the use of mobile phones for the self-report of psychological well-being during pregnancy Helping to understand barriers and enablers of digital screening |
EPDS-10; BrightSelf App; self-report | Qualitative; Tatar’s Design Tensions Framework | Individual design sessions; Group design sessions; Skype design sessions | Thematic Analysis | Individual design sessions; 5 Group design sessions; 6 Skype design sessions | Low/Moderate |
| 6 | Drake et al. (2014) | United States (Southern) | Women (Postnatal); healthy volunteers | 18 | Health Sciences Centre; Public Health |
To develop innovative methods of screening women for the symptoms of PPD to facilitate referral and treatment Helping to understand the barriers and enablers of digital screening; helping to understand the efficacy, feasibility and acceptability of digital screening |
EPDS-10 (online/Internet); Laptop | Mixed-Methods (Descriptive); Exploratory; Qualitative methods | Focus Groups; Individual interviews; Online screening intervention | Thematic Analysis | Self-administered EPDS 2–3 months postpartum | Low/Moderate |
| 7 | Dyurich & Oliver (2020) | South Texas; United States | Women (pregnant) | 6 | Maternal–fetal Clinic |
To explore the lived experiences of pregnant women using an electronic intervention to screen for and manage symptoms of perinatal depression and promote wellness during pregnancy Helping to understand the barriers and enablers of digital screening |
EPDS-10; VeedaMom mobile App | Qualitative – Individual; Phenomenological Study | Lived experience; in App journal; Semi-structured interviews; Focus Groups; preliminary themes | Thematic Analysis; Focus Groups | EPDS completed once a week for 6 weeks | Low/Moderate |
| 8 | Faherty et al. (2017) | Philadelphia, Pennsylvania, United States | Women (prenatal) | 36 | University Hospital |
To examine, using a smartphone application, whether mood is related to daily movement patterns in pregnant women at risk for perinatal depression Helping to understand the feasibility of digital screening to monitor perinatal depression |
Application administered surveys (Ginger.io) (PHQ-2 (daily) & PHQ-9 or GAD-7 administered weekly | Quantitative; Cohort Study (ecologic momentary assessment; randomised; Cohort) | Enrolment interview; Data collection via Ginger.io Application (PHQ-2; PHQ-9; GAD-7); mobility and radius data | Demographic factors compared between mild/moderate and moderately severe/severe depression at baseline; General linear mixed-effects regression models to estimate the association between mood and movement | 8-weeks | Moderate |
| 9 | Flynn et al. (2011) | Ann Arbor, Michigan, United States | Pregnant (n = 81) and Postpartum Women (n = 104) | 185 | Outpatient Psychiatry Clinic; University affiliated health care system |
To compare the utility of the EPDS with the PHQ in a sample of perinatal women seeking psychiatry services within a large health care system Helping to understand the effectiveness of digital screening |
Computerised versions of the EPDS-10 & PHQ-9 (PHQ-9 used a summary scoring algorithm and a diagnostic algorithm) | Quantitative – Non-RCT | Extracted archival data; EMR; unstructured Clinical Interview using DSM-IV by Clinician | Quantitative Analysis: Pearson correlations; Cronbach's coefficient alphas; Comparative AUC for ROC contrasts between EPDS and PHQ | 2 years and 3 months (extracted archival data) | Low |
| 10 | Fontein-Kuipers & Jomeen (2019) | Rotterdam, The Netherlands | Dutch-speaking pregnant women with uncomplicated pregnancies |
433 (T1) 343 (T2) |
Primary Care (Midwife- led) |
To investigate the validity and accuracy of the Whooley questions for routine screening of maternal distress in Dutch antenatal care Helping to understand the effectiveness of digital screening |
Whooley Questions (2-items); Arroll Question 1 question); EDS-10; STAI (20-items); PRAQ-R2 (10-items) (self-completed and digitally distributed) (Dutch version) | Quantitative – Cohort Study | Data collected digitally via self-report measures | Quantitative Analysis; proportion of maternal distress; reliability analysis of Whooley questions; diagnostic accuracy of Whooley items for depression, trait-anxiety, pregnancy-related anxiety; population prevalence of maternal distress; ROC analysis of EDS, STAI and PRAQ-R2 at T1 & T1 (Q1 &2) | 1 year and 11 months (data collection) | Moderate |
| 11 | Friedman et al. (2016) | East Harlem, New York, United States | Health Professionals (Pediatric Residents & Faculty); Mothers | Health Professionals (Pre-test n = 40; Post-test n = 30; Post-test who attended Conference (n = 17); Mothers in Chart Review (Group 1: 100; Group 2: 100; Group 3: 93) | Medical Centre |
The study examined the effects of an educational session about PPD and modification of the electronic medical record (EMR) on providers’ screening for PPD Helping to understand the effectiveness of digital screening |
EMR; PHQ-2 (Researchers integrated a screening tool into the EMR to screen for PPD; EMR template change) | Quantitative – Descriptive (pre-test-post-test Study Design) | Retrospective Chart Review of Mothers | Data were analysed using chi-square tests and Student’s t tests; Pre- & Post-test sample sizes and percentages | Retrospective Chart Review; Three time periods: Group 1 = before the conference; Group 2 = after the conference but before the EMR change and Group 3 = after screening in the EMR | Low |
| 12 | Gance-Cleveland et al. (2019) | Aurora, Colorado, United States | Prenatal providers; Prenatal patients; Clinicians – nurse-midwives; obstetrician, family nurse practitioner; certified nurse-midwife administrators | Prenatal providers (n = 9); Prenatal patients (n = 7); Clinicians – nurse-midwives (n = 7); obstetrician (n = 1), family nurse practitioner (n = 1); certified nurse-midwife administrators (n = 2) | Midwifery Clinic |
To develop StartSmart, a mobile health (mHealth) intervention to support evidence-based prenatal screening, brief intervention, and referral to treatment for risk and protective factors in pregnancy Helping to understand the enablers and barriers of digital screening |
GAD-2; GAD-7; PHQ-2; PHQ-9; AAS-2; NIDA Quick Screen; AUDIT-C; Pre-pregnancy BMI or GWG; GTT; Godin-Sheperd; Insomnia Severity Index | Qualitative – mHealth Development approach; Davis’ Technology Acceptance Model; Screening, Brief Intervention, Referral to treatment (SBIRT) framework; Cognitive engineering method | Interviews; Qualitative observations; Process Mapping; Focus Groups; Online Advisory Work Groups | Phase 1: Prototype development; Phase 2: Alpha testing; Clinician and patient testing and feedback | First prenatal visit; 28-week visit and 36- week visit | Low/Moderate |
| 13 | Gordon et al. (2016) | Philadelphia, Pennsylvania, United States |
Patients with history of depression in pregnancy; Prenatal providers; Social Workers/Care Managers; Mental health Specialists; Clinic Administrator; Support staff; Research staff; and a Programmer |
Patients with history of depression in pregnancy (n = 4), Prenatal providers (n = 2), Social Workers/Care Managers (n = 2), Mental Health Specialists (n = 2), Clinic Administrator (n = 1), Support staff (n = 3), Research staff (n = 2), and a Programmer (n = 1) |
Large hospital-based Outpatient Prenatal Care Centre |
To develop a suite of eHealth applications to improve the quality of perinatal mental health care Helping to understand the feasibility of digital screening to screen for perinatal depression |
Tablet-based, self-report screening tool PMD) using a 2-stage process with an initial 2-question screen & PHQ-9 | Qualitative – Participatory Design (Longitudinal); a rapid cycle iterative design approach | Participatory Groups; Feedback; Live action videography; Field Notes | Longitudinal Participatory Design approach; Development of 3 applications | 20 meetings over 24 months | Low/Moderate |
| 14 | Guevara et al. (2016) | Philadelphia, Pennsylvania, United States | Clinicians; Parents | Clinicians (n = 15); Parents (n = 1,816) | Hospital affiliated paediatric practices and Community Health Clinics |
To determine feasibility and acceptability of parental depression screening in high-risk urban paediatric practices Helping to understand the feasibility and acceptability of digital screening; helping to understand the barriers and enablers of digital screening |
EHR; electronic alerts/point of care reminders for Clinicians; electronic versions of the PHQ-2; automated scoring algorithm; suggested language for explaining positive screen to parents | Mixed-Methods (Qualitative & Quantitative components); Grounded Theory | Rates of depression screening using PHQ-2; Semi-structured interviews with Clinicians to identify barriers and facilitators to screening; Investigator Meetings; Screening of parents was conducted when they brought their child to the practice or clinic for a well child visit between the ages of 12 months and 36 months | Summary statistics on the number of eligible parents, depression screens administered, and positive screens by site were collected; Differences in proportions by site using chi- square statistics; Assessed for trends in the monthly proportion screened using a chi- square test of trend statistic; Thematic Analysis | 20-month screening period | Moderate |
| 15 | Guintivano et al. (2018) | North Carolina, United States; Australia | Women | 7344 (women with lifetime history of PPD) (US); 411 (Australia) | Lifetime episode of having PPD (US & Australia) (General Population) |
To develop an iOS App (PPD ACT) to recruit, consent, screen, and enable DNA collection from women with a lifetime history of PPD to sufficiently power genome-wide association studies Helping to understand the effectiveness of digital screening for PPD |
EPDS-lifetime (modified version; 21 questions) to assess lifetime history of PPD; 2nd EPDS assessment used a web-based form; PPD ACT | Quantitative – Cohort Study | Online screening for PPD depression symptoms using EPDS; Clinician diagnosis; Spit Kits; Biobanking | Descriptive statistics; State-level birth rate data; ICC’s to measure test–retest reliability for continuous variables; Binomial tests to measure agreement for binary variables; Squared weighted Cohen’s kappas to measure test–retest reliability for categorical variables | 1 year | Moderate |
| 16 | Hahn et al. (2021) | Aachen, Germany | Women (Mothers; Postpartum) | Cohort 1 (N = 308); Cohort 2 (N = 193) | University Hospital |
To explore whether an accurate prediction of PPD is feasible based on socio-demographic and clinical-anamnestic information as well as early symptom dynamics using remote mood and stress assessments Helping to understand the feasibility and acceptability of digital screening |
EPDS collected via remote online questionnaires sent via email; collected at all time points (T0-T4); personal and socio-demographic variables; Stressful Life Events Screening Questionnaire; Maternal Postnatal Attachment Scale (MPAS) | Quantitative – Cohort Study (Cohort 1 & 2); Longitudinal | Data collected at Clinic and remote online assessments (T0-T4); mood and stress assessments collected on a bi-daily basis; clinic assessments; clinical interview | Univariate analysis (χ2, N and p-value) of the first cohort; Logistic regression coefficients; Socio-demographic variables; birth complications; subjective birth-related trauma; PMS; postpartum blues; stressful life events; breastfeeding; within- and out-of-sample validation study design | 12 weeks (data collection) | Moderate |
| 17 | Hassdenteufel et al. (2020) |
Heidelberg, Germany |
Women (pregnant) | 597 | University Hospitals – Maternity Departments |
To examine the longitudinal interaction between exercise, general physical activity, and mental health outcomes in pregnant women Helping to understand the feasibility of digital screening |
EPDS-10; PRAQ-R (10-items); STAI-S; STAI-T (20 questions each) & physical activity levels using PPAQ (32 activities); Global Health Scale (GHS) (10 questions); completed on Tablets or Computers via self-report | Quantitative – Cohort Study (Prospective Longitudinal Study) | Online screening; Self-report | Cross-sectional and longitudinal analyses using Pearson’s correlation coefficient and multiple linear regression analyses | Digital assessment every 4 weeks from 2nd trimester until birth, as well as 3 & 6 months postnatally (1-year, 23 months data collection) | Low |
| 18 | Highet et al. (2019) | Melbourne, Australia | Women (pregnant) | 144 | Maternal and Child Health Clinic |
To evaluate a perinatal mental health digital screening platform, iCOPE Helping to understand the effectiveness of digital screening |
EPDS-10; psychosocial risk questions; iCOPE Digital Screening | Quantitative – Cohort Study (Descriptive) | iCOPE Digital Screening platform automatically recorded and scored the EPDS; produced instant clinical and client reports whilst collecting data in real time | Participant characteristics; psychosocial risk (n & %); mean screening time; rates of depression and anxiety (Cronbach’s α for EPDS administered digitally) | 12-month period (4–6-week postnatal check) | Moderate |
| 19 | Jiménez-Serrano et al. (2015) | Valencia, Spain | Women (postpartum) | No PPD: n = 1,237; PPD: n = 160 | General Hospitals |
To develop classification models for detecting the risk of PPD during the first week after childbirth, enabling early intervention and to develop an mHealth App for mothers and clinicians to monitor their results Helping to understand the effectiveness of digital screening |
EPQ-N (12-items); EPDS-10; Machine Learning; Risk Prediction; Mobile Phone App; eDPP Predictor | Quantitative – Cohort Study (Prospective) | Digital screening; Diagnostic Interview | Machine Learning (ML); Pattern Recognition (PR); Naive Bayes Model; Logistic Regression; artificial neural network (ANN); support vector machines (SVM) | 11-month period (at childbirth; Week 8 and at Week 32 after childbirth) | Moderate |
| 20 | Johnsen et al. (2018) | Copenhagen, Denmark | Women (pregnant) | 15 | Antenatal Care Facility (1st Midwifery visit) |
To explore women's experiences of self-reporting their health status and personal needs online prior to the first midwifery visit, and how this information may affect the meeting between the woman and the midwife Helping to understand the barriers and enablers of digital screening |
Email link to a self-report Questionnaire; socio-demographic characteristics, reproductive, obstetric, and medical history, general health status, intake of dietary supplements, lifestyle factors before and during current pregnancy, WHO-5 Well-being Index, and Cambridge Worry Scale | Qualitative | Individual semi-structured Interviews; Structured observations of first midwifery visit | Conventional Content Analysis was used to analyse data; categories developed (main and sub-categories) | 15th gestational week (1st midwifery visit); 1 year of data collection | Low |
| 21 | Kallem et al. (2019) | Philadelphia, Pennsylvania, United States | Women | 195 (Received Services (n = 23) Did Not Receive Services (n = 172) | Urban Primary Care Practice (2-month Well Child Visit) |
To determine mental health care use among women with Medicaid insurance 6-months after a positive PPD screen and to determine maternal and infant factors that predict the likelihood of mental health care use Helping to understand the effectiveness of digital screening |
EPDS-10 (English & Spanish); Tablet Screening in waiting room; Self-Report | Quantitative – Retrospective, Population-based Cohort Study | A linked dataset of the child’s electronic health records, which includes the PPD screens of Mothers, maternal Medicaid claims, and birth certificates were used | Bivariate analyses (Chi-square and t test) were conducted comparing the maternal and infant factors of mothers who completed the EPDS and did not complete the EPDS; Multivariate logistic regression was used to estimate maternal and infant clinical and sociodemographic factors that predict service use | 2-month Well Child Visit; 2 years and 11 months (data collection) | Moderate |
| 22 | Kim et al. (2007) | Minneapolis, Minnesota, United States | Women (prenatal) | 54 | Medical Centre (University affiliated Public Hospital) (routine prenatal visit) |
To test the feasibility of using Interactive Voice Response (IVR) technology to screen for depression among low-income, urban pregnant patients and to solicit their preferences for treatment Helping to understand the acceptability and feasibility of digital screening |
Interactive Voice Response (IVR) technology; automated phone version of the EPDS-10; Treatment Module (7 questions) |
Quantitative – Cohort Study; convenience sample; pilot study | IVR—Introduction module; Depression screen module & Treatment module | Quantitative outcomes of interest were completion rates for the IVR screening and the percentage of women with mild to severe depressive symptoms. Research outcomes included reports of patient satisfaction (n & %) with the system along with their preferences for an intervention | One-month study period; two different weekly prenatal clinics | Moderate |
| 23 | Kingston et al. (2017) | Edmonton, Alberta, Canada | Women (pregnant) | N = 636; Paper-based screening group n = 331; E-Screening group n = 305 | Community and Hospital-based Antenatal Clinics and Hospital-based prenatal classes (Maternity Clinics) |
To evaluate the feasibility and acceptability of Web-based mental health e-screening compared with paper-based screening among pregnant women and to identify factors associated with women’s preferences for e-screening and disclosure of mental health concerns Helping to understand effectiveness over paper; helping to understand the feasibility and acceptability of digital screening |
Web-based mental health e-screening; The intervention group completed the ALPHA (15 risk factors) and the EPDS-10; Tablet computer; Women in the Control Group completed paper-based versions of the ALPHA and the EPDS, followed by the web-based baseline questionnaire; MINI | Quantitative—Parallel-group, Randomized Controlled Superiority Trial | E-Screening Intervention; Paper-Based Screening Control Group | Adapted version of Renker and Tonkin’s tool of feasibility and acceptability; ITT analysis; Baseline differences in groups were compared using independent t tests (means) and chi-square tests (%); Descriptive data (frequencies and 95% CIs; means and SDs) to describe the sample | 1 year 5 months (data collection) | Low |
| 24 | Lupattelli et al. (2018) | Western Europe; Northern Europe; Eastern Europe | Women (Antenatal and Postnatal) | 8069 | Online (Anonymous) |
To explore the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity Helping to understand the prevalence of antenatal and postnatal depression |
EPDS-10; Electronic questionnaire; Questback | Quantitative – Cross-Sectional Study | Data were retrieved from the “Multinational Medication Use in Pregnancy Study,” a cross-sectional, web-based study carried out in Europe, North and South America, and Australia to investigate patterns and correlates of medication use in pregnancy | Descriptive statistics; IPTW, using the propensity score to survey data; logistic regression; crude and adjusted β coefficients with 95% CI | 5 months (data collection) | Moderate |
| 25 | Marcano-Belisario et al. (2017) | England, United Kingdom | Women (pregnant) | 530 | General Practice, Community or Hospital centres (NHS) Antenatal Clinics |
To assess the feasibility of using tablet computers in the waiting area of antenatal clinics for implementing the recommendations of the NICE guidelines for recognising antenatal depression Helping to understand the feasibility of digital screening |
Whooley questions (2-items); EPDS-10; Socio-demographic survey (11 questions); Tablet computers; scrolling and paging format; Snap Mobile App | Quantitative – Randomised Controlled Trial | Use of tablet computers to collect socio-demographic data; complete Whooley & EPDS items; survey layout (scrolling and paging); Snap WebHost | Completion times (median, mins, secs); proportion; median; chi-square; sample sizes and percentages | 8 months (recruitment of participants) | Moderate |
| 26 | Pineros-Leano et al. (2015) | Illinois, United States |
Staff members (7 nutritionists; 5 nurses; 3 case managers, 3 administrative Assistants; 3 intake specialists; 4 program coordinators |
25 | Public Health Clinic |
To explore the attitudes and perceptions staff members towards incorporating mHealth technology in a public health clinic to screen for depression Helping to understand the barriers and enablers of digital screening |
Staff perceptions related to depression screening with tablet technology | Qualitative | Focus Groups; Semi-structured interview guide; audio recorded; transcribed verbatim | Thematic Analysis (Focus Group Data) | 1 month (data collection) | Low |
| 27 | Poleshuck et al. (2015) | New York, United States | Women (pregnant/non-pregnant) | 159 | Women’s Health Clinic |
To determine the feasibility and acceptability of an electronic psychosocial screening and referral tool; developed and finalized a prioritization tool for women with depression; and piloted the prioritization tool Helping to understand the acceptability and feasibility of digital screening |
An electronic psychosocial screening and referral tool; Promote-W uses primarily standardized screening tools; PHQ-9; a tablet computer with the Patient Navigator in the clinic; WHO-QOL scale; Client Satisfaction Questionnaire (patient satisfaction) | Quantitative – Clinical Trial/randomized comparative effectiveness—RCT | Community Advisory Board; Focus Groups; Individual patient input | Analytic plan—growth curve analysis; quadratic effects; cross-sectional mean differences using ANCOVA; moderation effects; latent class analysis | Participants are assessed at baseline, at 4-months immediately post-treatment, and at 3- and 6-months following the end of treatment at any safe location of their preference, or by phone if necessary | Low |
| 28 | Quispel et al. (2012) | Rotterdam, The Netherlands | Women (pregnant) | 621 | Obstetric Clinic (University Hospital); Community Midwifery Practice |
To explore the reliability, validity (predictive value) and feasibility of the GyPsy approach under routine practice conditions in Rotterdam, the Netherlands Helping to understand the effectiveness and feasibility of digital screening |
EDS-10 (Dutch version); GyPsy Screen and Advice; Self-report questionnaire; PDA | Quantitative – Cohort Study (Observational & Exploratory) | PDA questionnaire; caregiver showed screen result and provided women advice or provided other specific care | Cronbach’s α coefficient; intraclass correlation coefficient, Cohen’s κ and Kendall’s τ-b. Criterion validity NPV; PPV secondary measure; risk profiles and to describe feasibility judgements they used conventional descriptive and comparative statistics; Posthoc Bonferroni adjusted pair wise comparisons were performed to identify any group related difference; Power 0.80 and p value < 0.05 | 1 year 11 months (data collection); 43 women completed retest of EDS | Moderate |
| 29 | Martinez-Borba et al. (2019) within Cipresso, Serino & Villani (2019) | Spain | Women (perinatal) | 523 | Health Collaborating Centres; Community recruitment |
To compare the feasibility, usability, and user satisfaction of two devices (web vs. mobile application) of an online program for perinatal depression screening called HappyMom (HM) Helping to understand the acceptability and feasibility of digital screening |
EPQ-R (48-items), STAI-T (20-items), ERQ (10-items), CAE (42-items), QLI (33-items) and SRSS (43-items); HM-Web and HM-App |
Quantitative – Longitudinal; Cohort Study |
Two evaluations were made during pregnancy (weeks 16–24 and 30–36 of gestation) and three in the postpartum (weeks 2, 4, and 12 after delivery). The assessment points were the same for both devices |
Descriptive analysis of the sample; Analysis of dropout rates (proportion of women who completed each assessment in relation to women who were registered into the program); Exploration of women’s usability reports and satisfaction with HM | 4 years (data collection) | Moderate |
| 30 | Shore et al. (2020) | Colorado, United States | Women (perinatal) | 135 (referred patients) | Women’s Clinic |
To describe the implementation of the first known telepsychiatry-enabled model of perinatal integrated care and to report initial results following implementation Helping to understand the effectiveness of digital screening |
PHQ-9; EPDS; Tablet computer | Quantitative – Cohort Study; Quality Improvement Study; descriptive design; convenience sample; pilot study | PHQ and EPDS completed electronically on a tablet computer; demographic data and diagnoses; satisfaction surveys; biannual reports; EHR | Descriptive analyses on patient characteristics, process measures and outcome measures (%, N, χ2,df, p-value) | 14 months (data collection); Satisfaction surveys were distributed to a convenience sample of patients in September 2017 and July 2018 | Low/Moderate |
| 31 | Tsai et al. (2014) | Khayelitsha, Cape Town, South Africa | Women (pregnant) | Study 1 N = 1,144 and Study 2 N = 361; Total N = 1,505 | Community Health |
To determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones Helping to understand the effectiveness and feasibility of digital screening |
EPDS-10 (Xhosa version); Mobile Phone; Survey software | Quantitative—Cross-Sectional Study (× 2) | EPDS completed on a mobile phone (EPDS-7, EPDS-5, EPDS-3, EPDS-2) | Cronbach’s α coefficient; Pearson correlation coefficient; calculating sensitivity, specificity, and likelihood ratios using standard formulas; ROC curves, calculating the area under the ROC curve (AUC) using the trapezoidal rule and comparing AUC values using the algorithm | Study 1—These data were collected from May 13, 2009 to September 29, 2010 in 24 non-contiguous neighbourhoods of Khayelitsha; Study 2—May 1, 2010 through February 18, 2011 | Moderate |
| 32 | Willey et al. (2020) | Melbourne, Australia | Women (pregnant) refugee and migrant | N = 22; refugee background (n = 17) migrant (n = 5) backgrounds | Antenatal Clinic |
To determine if a digital perinatal mental health screening program is feasible and acceptable for women of refugee background Helping to understand the feasibility and acceptability of digital screening |
EPDS-10; iCOPE | Qualitative – Evaluation Study | Focus Groups; Semi-structured interviews; use of Interpreters to assist women who couldn't speak much English | Thematic analysis – inductive and deductive approach; saturation of themes; hybrid approach to thematic analysis was utilised | 4 months (data collection) | Low |
| 33 | Woldetensay et al. (2018) | Ethiopia (South-Western—rural) | Women (pregnant) | 4680 | Community |
To describe the prevalence of prenatal depressive symptoms and whether it is associated with maternal nutrition, intimate partner violence and social support among pregnant women in rural Ethiopia Helping to understand the prevalence of prenatal depressive symptoms |
Depressed mood was assessed using PHQ-9; MUAC; HemoCue Hb 301 system; Household Food Insecurity Access Scale; Socio-demographic variables; Obstetric factors; IPV (HITS assessment); MSSS; Data collection was conducted electronically using ODK software; handheld tablets; submitted to a secured server via an internet connection | Quantitative – Cohort Study (Prospective, Community based, Birth Cohort Study—Open; Quasi-Experimental) | Data collection was conducted electronically on handheld tablets and submitted to a secured server via an internet connection | Percentages; Confidence Intervals; Odds Ratios; p-values | 2 years (data collection) | Moderate |
| 34 | Wright et al. (2020) | Auckland, New Zealand | Community Midwives; Women (antenatal and postnatal) | Midwives (N = 5); Women (N = 20) | Hospital |
To assess the acceptability and feasibility of the Maternity Case-finding Help Assessment Tool (MatCHAT), a tool designed to provide e-screening and clinical decision support for depression, anxiety, cigarette smoking, use of alcohol or illicit substances, and family violence among pre- and post-partum women under the care of midwives Helping to understand the acceptability and feasibility of digital screening; helping to understand the barriers and enablers to digital screening |
MatCHAT app; included brief smoking, drinking and other drug use questions; the Patient Health Questionaire-2 (PHQ-2) for depression, with the full Patient Health Questionaire-9 (PHQ-9) triggered when PHQ-2 positive; an anxiety question triggering the General Anxiety Disorder-7 (GAD-7) when positive; and four questions regarding family violence | Mixed Methods Research; Co-design; Quantitative and Qualitative components; Grounded Theory; general inductive approach |
Semi-structured interviews; data collection via MatCHAT app program via a web link included numbers of screens completed, positive cases, participants who wanted help and the level of care recommended, and ratings of acceptability, feasibility and utility from online surveys |
Descriptive statistics; general inductive approach to thematic analysis of Qualitative themes | 8-months | Low |