closing the northern gap: care provider perspectives on the suitability of an ehealth app for maternal mental health in northwestern ontario
abstract
maternal depression affects up to 25% of women during the perinatal period; however,
less than 10% of these women go on to receive adequate mental healthcare (andersson et al.,
2004; bailey, 2001; cox, sowa, meltzer-brody, & gaynes, 2016; de tychey et al., 2005; gavin et
al., 2005; hostetter & newport, 2005). women living in northwestern ontario (nwo) face a
number of unique barriers that further restrict their access to maternal mental health supports.
technological advances in ehealth interfaces may represent novel solutions for overcoming
these obstacles. the hope app is an e-screening, e-referral, and e-therapy tool with a single,
virtual point of access that has been designed to screen, diagnose, monitor, and treat mood and
anxiety disorders in pregnant and postpartum women. the primary objective of this qualitative
study was to understand maternal care and social service providers’ perspectives on potential
barriers and facilitators to using the hope app in nwo. the providers were asked to share
their perspectives on the following three research questions: (1) what barriers or facilitators
currently exist in the delivery of, access to, and use of existing maternal care services and
supports in nwo? (2) what barriers or facilitators exist in the delivery of, access to, and use of
the hope app in nwo? (3) what changes could be made to the current hope app in order to
facilitate an improved fit to the specific needs of care providers and women (as perceived by
care providers) living in nwo? semi-structured, in-depth interviews were conducted with ten
service providers representing various maternal care disciplines in thunder bay and kenora.
five major themes and twenty-one sub-themes were identified and analyzed using an
interpretive description approach. notably, the participants acknowledged twenty distinct
obstacles to maternal care in northern communities which could be organized under the
following four subsets: individual-level factors, social determinants of health, ecological
determinants of health, and structural barriers. prominent obstacles to maternal care included –
among others – the lack of specific maternal mental health services, limited transportation
options, diminished internet access, and the shortage of primary care providers. overall, the
social service and care providers viewed the hope app as a helpful tool for improving maternal care delivery and access, with six strong stipulations: (1) the content and images must
be modified to suit women in nwo; (2) the resource lists must be localized; (3) the content
must be culturally expanded in consultation with the communities of interest; (4) the high-risk
referral protocol must be re-evaluated for safety; (5) coaches must reside in nwo and should be
representative of demographics if at all possible; and (6) coaches must be reachable by
telephone, email, text message, and wifi-based chat. the principal concerns for using the app in
nwo was the reliability of internet connectivity in smaller rural and remote communities.
when asked if they would feel comfortable referring women to the hope platform, the
response from service providers was overwhelmingly positive. these findings suggest that the
hope app may represent a beneficial addition to the services currently offered in nwo,
particularly after region-specific modifications have been made. the providers suggested that
addendums to the app should focus on expanding its visuals and content to better represent the
diverse populations of women living in the north. following revision, further research should
include direct input from women using this service.
collections
related items
showing items related by title, author, creator and subject.
-
constructing bodies of knowledge: examining the discursive sites through which individuals come to understand what "health" means
peterson, jasmine (2015-02-02)how individuals perceive and understand health will impact the health behaviours that they en-gage in, how they engage with the healthcare system, and how they perceive themselves on a spectrum of healthfulness. perceptions ... -
interprofessional care in a community mental health outpatient program: client outcomes at discharge and follow-up
tippin, gregory k. (2013-02-03)increased collaboration between health professionals has been identified as a means of improving the quality of client care while operating within the constraints of a publicly funded health care system. one such model of ... -
the association between supervisor mental health training and workplace mental health stigma
viel, christopher d. (2019)mental health disorders (mhd) are a major cause of human suffering, lost productivity, workplace disability, and economic loss throughout the industrialized world. they can affect people’s thoughts, behaviours, and feelings, ...