App-Based Ecological Momentary Assessment to Enhance Clinical Care for Postpartum Depression: Pilot Study (Preprint)

BACKGROUND Wearable tracking devices and mobile health technology are increasingly used in an effort to enhance clinical care and delivery of personalized medical treatment. Postpartum depression is the most frequently diagnosed complication of childbirth but significant gaps in screening and treatment remain. OBJECTIVE We investigated the clinical utility and acceptability of using ecological momentary assessment to collect daily mood, sleep, and activity data through the use of an Apple Watch and mobile app among women with postpartum depression. METHODS This was a pilot study consisting of three in-person research visits over the course of a 6-week enrollment period. Questionnaires to assess depression, anxiety, and maternal functioning were periodically collected, along with daily self-reported symptoms and passively collected physiological data via an Apple Watch. Feedback was collected from study participants and the study clinician to determine the utility and acceptability of daily tracking. Compliance with daily ecological momentary assessments was also measured. RESULTS Of the 26 women enrolled, 23 completed the 6-week study. On average, participants completed 66.7% of all active daily assessments and 73.9% of all passive measures. Further, all 23 participants completed the three required visits with the research team. CONCLUSIONS Using ecological momentary assessment to track daily symptoms of postpartum depression with a wearable device was largely endorsed as feasible, acceptable and clinically useful by participants and the study clinician and could be a innovative solution to increase care access during the COVID-19 pandemic.