A technology-enabled service for perinatal collaborative care models: A randomized clinical trial

Area of Science:

• Perinatal mental health
• Collaborative care models
• Digital health innovations

Background:

• Perinatal mental health conditions are prevalent and often undertreated.
• Collaborative care models enhance access but face workflow and scalability challenges.
• Digital innovations offer potential solutions for improving perinatal mental health care delivery.

Purpose of the Study:

• To evaluate a technology-enabled service designed to streamline care manager workflow in perinatal collaborative care.
• To compare the impact of this service versus usual collaborative care on depression and anxiety symptoms, patient satisfaction, and engagement.

Main Methods:

• A randomized controlled trial involving 75 pregnant or postpartum individuals with depression or anxiety symptoms.
• Participants were randomized to either a technology-enabled service (CBT app, text coaching, dashboard) or usual perinatal collaborative care.
• Symptom assessment (PHQ-9, GAD-7) occurred biweekly for 12 weeks; outcomes included symptom response, remission, stepped care, satisfaction, and engagement.

Main Results:

• Both groups showed improvement in depression and anxiety symptoms over time, with no significant differences between the technology-enabled service and usual care.
• Symptom response and remission rates were comparable between the groups for both depression and anxiety.
• Patient engagement was higher in the technology-enabled service group at mid-study, while patient satisfaction was similar across both groups.

Conclusions:

• While the technology-enabled service did not yield significant clinical improvements in depression or anxiety symptoms compared to usual care, it enhanced patient engagement.
• These findings suggest that digital tools may not directly improve clinical outcomes but can potentially enhance the operational efficiency, scalability, and sustainability of perinatal collaborative care.