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Text messaging feasible, inexpensive adjunct therapy for postpartum depression

Supportive text messages sent to low-income mothers with postpartum depression were practical and inexpensive and may be an option as an adjunct therapy, according to a recent study.

“The study shows that text messaging is another way to make contact with a group that has an extreme need,” Matthew A. Broom, MD, assistant professor of pediatrics at Saint Louis University and SLUCare physician at SSM Cardinal Glennon Children’s Medical Center, said in a press release. “This is a relatively low-cost way to reach people.”

Researchers enrolled 58 at-risk mothers who scored a 10 or higher on the Edinburgh Postnatal Depression Scale following a standard postpartum depression screening. Most of the participants were black (83%) with an annual income of < $25,000. Cognitive behavioral therapy was administered to all participants, according to researchers.

As an adjunct to therapy, text messages were sent to participants four times per week for 6 months. The messages integrated informational, motivational and reflective statements such as “Smoking is unhealthy for you, your baby, and other family members,” “Your happiness depends on what you do…” and “No one can make you feel inferior without your consent.” All participants also had access to support from social workers and telephone assistance.

According to the results, 93% of participants received 86.1% of the 4,790 text messages, indicating high feasibility. The total text message cost was $777.60, which was “considerably less than anticipated,” according to the researchers.

Twenty-six percent of the 96 scripted messages included a phone number for participants to call and 39% prompted participants to reply with “yes” or “no” as to whether they wanted to receive a follow-up call. Of 1,616 messages sent that allowed for a response, 118 were responded to; 66.1% requested a follow-up call and nearly half of the participants responded to a text message at least once.

“There is a cultural norm in this community of strength, of absorbing whatever comes at them,” Broom said in the release. “We want to break that barrier that equates reaching out for help as weakness.”

Twenty-eight participants completed an exit survey and most (89%) said the text messages were motivating, had a positive influence on their symptoms and were easy to comprehend. Furthermore, 82% said the messages were personally relevant and 75% shared them with others.

“Moms that are well from a mental health perspective have children with better developmental outcomes,” Broom said in the release. “If we can provide more support and services for the high-risk mothers we serve, we will be able to create a greater positive impact for their children.” – by Stephanie Viguers

Disclosure: The study was sponsored by the Maternal, Child and Family Health Coalition. Broom reports receiving salary as a co-investigator from Josiah Macy Jr. Foundation’s Institute on Medicine as a Profession and being an investigator for the SSM Cardinal Glennon Foundation Fleur de Lis Program. Please see the study for a list of all others authors’ relevant financial disclosures.