The purpose of the study is to determine if access to a text-message based holistic chatbot support program "Healing at Home 2.0" decreases depressive symptoms as measured by the Edinburgh Postnatal Depression Scale (EPDS) compared to usual postpartum care for patients of color.
Healing at Home (H@H) 2.0 is a comprehensive technology-based postpartum support program which provides 24/7 support to individuals through use of an SMS chatbot for six weeks postpartum. This will be a randomized controlled trial (RCT) with an intervention arm consisting of patients who are planning to be discharged at routine timing (as determined by their clinical team) with access to H@H 2.0 postpartum SMS chatbot platform and a control arm which consists of usual postpartum care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
156
Healing @ Home 2.0 is a clinically used comprehensive technology-based postpartum support program, which provides 24/7 support to individuals through use of a text message based chatbot for six weeks postpartum. Content of H@H 2.0 includes anticipatory guidance regarding physical recovery, infant care and feeding, clinical algorithms to respond to urgent patient needs.
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
RECRUITINGEdinburgh Postnatal Depression Scale (EPDS) Screening Score
Scores from the validated EPDS screening tool will be calculated using standard scoring criteria for each of the 10 items. A score of 9 or greater or indication of suicide ideation will be used to indicate a positive depression screen.
Time frame: At 6 weeks postpartum
Postpartum visit attendance
Whether or not the patient attended their routine postpartum visit which should occur around the 6-week postpartum mark. We will accept routine postpartum visits up to 12-weeks postpartum.
Time frame: Up to 3 months postpartum
Count of unscheduled emergency room/postpartum triage visits
The number of unscheduled visits, reason for visit, whether or not patient was admitted to hospital in the first 6 weeks postpartum will be counted
Time frame: Up to 6 weeks postpartum
Mode of feeding
Patient asked mode of feeding at two time points. Options are exclusively breastfeeding, formula feeding only, or both breast and formula feeding.
Time frame: At baseline and 6 weeks postpartum
Scores of self-efficacy in infant care
Scores from the validated Self-efficacy in the Nurturing Role (SENR) tool will be calculated using Likert scale scoring criteria for each of the 16 items. Negative items are reverse-scored such that higher scores on the items always reflect greater self-efficacy.
Time frame: At baseline and at 6 weeks postpartum
Knowledge of postpartum warning signs
Using a question from the Pregnancy Risk Assessment measure survey (PRAMS) to ask patients to identify warning signs of complications that can occur after birth
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: At baseline and at 6 weeks postpartum
Score of Postpartum sleep: quality
One question Likert scale ranking quality of sleep from terrible to excellent.
Time frame: At baseline and at 6 weeks postpartum
Postpartum sleep: hours
Average number of hours slept in the past 7 days.
Time frame: At baseline and at 6 weeks postpartum
Postpartum pain score
Scores from a 10-item question from the validated Brief Pain Inventory short form will be calculated using Likert scale scoring criteria with scores ranging from 0-100. Higher scores mean higher pain.
Time frame: 24 hours prior to discharge from hospital
Social support and maternal functioning score
Scores from the validated Barkin Index of Maternal Functioning tool will be calculated using Likert scale scoring criteria for each of the 20 questions. The total score ranges from 0 to 120, with a score of 120 representing perfect functioning.
Time frame: At 6 weeks postpartum
Implementation outcome: Acceptability of Intervention Measure
4-item Likert scale where scores can range from 4 to 20. High scores indicate higher acceptability. Given to the intervention group only.
Time frame: At 6 weeks postpartum