SLU study explores feasibility of using text messages for minority mothers with postpartum depression

A Saint Louis University research paper published online March 16 in JMIR Mental Health explores the feasibility of helping low-income mothers through postpartum depression using text messages.

Corresponding author Matthew A. Broom, M.D., assistant professor of pediatrics at Saint Louis University and SLUCare physician at SSM Cardinal Glennon Children's Medical Center, formed the Happy Mothers, Healthy Families program in 2013 with a three-year, $316,140 grant from the Maternal Child and Family Health Coalition (MCHFC).

Other authors include Amy S. Ladley, Ph.D. and Elizabeth A. Rhyne, R.N. CPNP, of SSM Cardinal Glennon Children's Medical Center and the Saint Louis University School of Medicine Department of Pediatrics, and Donna R. Halloran, M.D., MSPH, associate professor of pediatrics at SLU and a SLUCare physician at Cardinal Glennon.

The objective of the study was to evaluate the feasibility of sending supportive text messages to low-income mothers of racial and ethnic minority backgrounds with postpartum depression and gauge the perception of receiving such message for depression.

Mothers found to be at risk received supportive text messages four times a week for six months, in addition to receiving access to traditional counseling services in an academic pediatric office. By the end of the research period, 4,158 text messages (86.1 percent of those sent) were successfully delivered to 54 mothers.

Between December 2012 and June 2014, screenings for postpartum depression occurred as a standard practice for all mothers coming into Cardinal Glennon for a well-child visit for an infant between seven days and six months old. English-speaking mothers living in the City of St. Louis who scored above 10 on the Edinburgh Postnatal Depression Scale (EPDS) were approached to join the study by members of the research team.

Each participant received the same, non-randomized message script without repeat over the six-month time frame. The messages were developed by members of the project team. Some of the messages allowed for a yes/no response in regards to whether the mother would like a follow-up phone call. The messages ranged from informational ("Having a routine is comforting for babies.") to motivational and reflective ("Today let's focus on making decisions from the facts not our feelings.")

Broom noted that most of the study's participants were unmarried and did not have a deep support system.

"There is a cultural norm in this community of strength, of absorbing whatever comes at them," Broom said. "We want to break that barrier that equates reaching out for help as weakness."

The paper finds that text messaging is a relatively low-cost and feasible way to serve as adjunct therapy to provide private support for at-risk mothers suffering from postpartum depression.

"The study shows us that there is another way to make contact with a group that has an extreme need," Broom said. "This is a relatively low-cost way to reach people."

Broom noted that improving maternal health, including a mother's mental state, is good for her child.

"Moms that are well from a mental health perspective have children with better developmental outcomes," he said. "If we can provide more support and services for the high-risk mothers we serve, we will be able to create a greater positive impact for their children."