Date Published: July 12, 2017
Publisher: Public Library of Science
Author(s): Michaela Sprenger, Tobias Mettler, Jorge Osma, Gabriele Fischer.
Our study focuses on exploring (1) the intention of health professionals to use and recommend e-mental health applications, (2) how this intention of health professionals might be influenced, (3) which group of health professionals might be most accessible to promote e-mental health applications for maternal depression, and (4) for which tasks they rate them to be most useful.
Based on a questionnaire informed by the theory of planned behavior, we collected 131 responses of U.S., Spanish, and Swiss health professionals in the field of pregnancy and maternal care (including psychologists, psychiatrists, midwives, and doctors) by means of an online survey. We analyzed the gathered data applying a structured equation model.
Our study reveals that health professionals would in general intend to recommend and use e-mental health applications. However, their attitude towards e-mental health applications varies regarding the respective use cases and also differs among health professions.
We offer three alternative propositions for private or public organizations, associations, or any other entity whose purpose is service to the community for introducing e-mental health applications into practice.
Being pregnant and becoming a mother is for most women a life-changing experience. However, not all women can cope with the new situation as emotional changes might cause maternal depression. This kind of depression includes all depressive conditions that occur either during pregnancy or within the first twelve months following delivery . The percentage of women affected by maternal depression is significant: Depressions during pregnancy affect 38%  and 6 to 19.5%—depending on the country of reference—suffer from depressive conditions after giving birth [3, 4].
Overall, our study has important implications for research and practice. From an academic perspective, we conducted—to our knowledge—the first survey that concentrated on the different groups of health professionals involved in maternal treatment and care (doctors, midwifes, nurses, psychologists, psychiatrists) and on their perspective towards e-mental health applications in the context of maternal depression. By applying the theory of planned behavior, our study provides insights on the behavioral intention of health professionals and on the underlying factors. Moreover, we evaluated the perceived usefulness of the application per mental healthcare process step and per health profession. Thereby, our study goes one level deeper by not only focusing on behavioral intention overall, but by also giving insights on which process step(s) e-mental health applications are judged to be of most value for and which groups of health professionals are most accessible for promoting these applications. In view of the usefulness of e-mental health applications per process step and health professional group, the above presented results show that there are differences between distinct professional groups. Overall, psychologists and psychiatrists attribute a lower level of usefulness to each process step compared to the other surveyed health professionals. Still, they judge e-mental health applications for maternal depression as useful for screening, prevention program, follow-up, and positive psychology intervention. In contrast to the other health professions, they do not value e-mental health applications for the treatment or assessment and diagnosis of maternal depression. When it comes to the question how e-mental health applications could be promoted, we would like to offer three propositions (Fig 4), which we describe next.
The insights presented in this paper are relevant from a practical point of view. Service providers aiming at developing an e-mental health application for maternal depression can use the results of our paper to inform the design of their service (e.g. which steps of the general mental healthcare process should be covered by the application) as well as the corresponding go-to-market approach (e.g. which group of health professionals would support the application; how could other groups be convinced of its value).