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The Hope Project app

With most everyone having a smartphone these days, people are using apps to support their health. There are a few apps directed to pregnant women about their substance use and mental health. Some recent efforts developed together by researchers and health providers show how these apps can be used to offer focused information and support to pregnant women.

A perinatal mental health research project in Alberta, The Hope Project, is exploring how e-technology can be used to support pregnant women with mental health concerns. Dr. Dawn Kingston and her team at the University of Calgary developed an app for screening and treating pregnant women experiencing anxiety and depression. It provides information, support, and help to women in the research study whenever they need it. The project will also look at how this intervention affects post-partum depression and the health of their children.

SmartMom Canada, was developed as part of a study from the University of British Columbia. Through text messaging, Optimal Birth BC provides women in Northern BC with prenatal education endorsed by the Society of Obstetricians and Gynaecologists of Canada (SOGC). Many of these women live in rural areas and may have limited access to prenatal care. Women who enroll in the study complete a confidential survey and then receive personalized text messages that include pregnancy tips, info on health topics, and available resources in their own community.

SmartMom Canada app

Women outside of these studies may find it challenging to find similar apps. Popular pregnancy apps do not offer much info or ideas for resources for women with mental health or substance use issues. One that has been positively evaluated is Text4baby in the U.S. The sponsors partner with national, state, and private organizations and offer local resource information in some states. Also available to Spanish speakers, an evaluation of the app can be found here.

As well, apps are being targeted to health care providers on improving the care they provide. A preconception care app available to physicians provides them with information from the National Preconception Health and Health Care Initiative and makes suggestions for responding to patient questions. Research is being done on using an app to provide motivational interviewing interventions to pregnant women who use substances.

Most apps available on smartphones are directed toward the general population and seek a large user base. Mental health apps and substance use apps that might support prevention, are not designed specifically for women, pregnant or not. And most pregnancy apps focus on fetal growth and “kick counters”, the woman’s weight and blood pressure, and checklists to get ready for a child.

So, while there is an app for everything, they may not an app for everyone. However, healthcare technology is growing at a fast pace, so hopefully we will see more apps in future that can expand FASD prevention efforts.

Related topics:

TEXT4BABY PROGRAM IN THE UNITED STATES: CAN TEXT MESSAGING BE AN EFFECTIVE ALCOHOL BRIEF INTERVENTION? February 2, 2015

HEALTHY PREGNANCY, HEALTHY BABY TEXT MESSAGING SERVICE IN TANZANIA December 17, 2013

Findings from an innovative peer support, outreach- and harm reduction-based pregnancy program for street-involved women

Pages from SROI HER Summary FINAL 2014

The Healthy, Empowered and Resilient (H.E.R.) Pregnancy Program uses professional staff and peer support workers to reach at-risk pregnant and parenting women in inner city Edmonton. The program, developed by Streetworks, supports street-involved women to access healthcare services before and throughout their pregnancy and address issues such as addiction, poverty and family violence.

The H.E.R. Pregnancy Program staff team is comprised of three pregnancy support workers who have street knowledge and experience as well as a registered nurse and social worker. It is primarily located within Boyle Street Community Services in Edmonton, Alberta.

Findings from a three-year evaluation of the program have recently been released. The evaluation included a photovoice project with clients, staff focus groups, key informant interviews with stakeholders, an analysis of program data, and a Social Return on Investment (SROI) analysis.

The findings of the study show a number of successes. Overall, the program is helping women to keep their babies and become parents. Women are being supported in accessing previously out-of-reach health and social resources and services (i.e., medical services, housing, and income assistance) and are experiencing a number of positive changes related to substance use and sexual practices. The evaluation findings also suggest that many women are feeling more empowered to stay safe and be involved in decisions about the care of their babies. Using highly conservative estimates of the number of clients impacted, the Social Return on Investment analysis suggests that every dollar invested in the program yields a return of $8.24 in social value.

Here’s a quick summary of some of the findings:

Who did the program serve?

  • 130 street involved pregnant women & 117 non-pregnant women received services/support from H.E.R. Pregnancy Program
  • 55% of pregnant women were between the ages of 20 and 29 and 83% were of First Nations, Inuit, or Metis ancestry
  • 63% of women had experienced previous pregnancies
  • 60 women gave birth, with H.E.R. staff attending 22% (or 13) of these births
  • On average, pregnant women visited the program 29 times from preconception through to the baby’s due date

Reducing or Stopping Substance Use

  • 76% of the 139 pregnant women reported substance use, typically alcohol (32%), marijuana, and other drugs
  • While connected with the program, women reported elimination of use (40%), safer use (37%), and reduction of substance use (26%) at least once during their pregnancy with the program

Improving Housing Outcomes

  • 22% of 78 pregnant clients who were homeless or unstably housed at program start moved into housing while with the program

Supporting Women in Keeping Custody of their Babies

  • Of 60 births, 53% (or 32) remained in the care of their mothers and 5 (8%) went into the care of family or friends.
  • 19 (32%) of births resulted in the baby being placed in care. For 2 (3%) of births, the babies were adopted
  • Children’s Services was involved in 30 of 60 (50%) of births. In 21 (70%) of births where Children’s Services was involved, women had a role in child placement decisions.
  • Many women who were unable to parent because of homelessness or other factors were able to explore alternative options for staying connected with their babies

For more on the H.E.R. Pregnancy Program, see earlier posts:

References

Charis Management Consulting Inc. (2013). Impact Evaluation of the H.E.R. Pregnancy Program – Program Data Report. Prepared by Charis Management Consulting Inc. for the Alberta Centre for Child, Family and Community Research.

Nathoo, T., Poole, N., Bryans, M., Dechief, L., Hardeman, S., Marcellus, L., Poag, E., Taylor, M. Voices from the community: Developing effective community programs to support pregnant and early parenting women who use alcohol and other substances. First Peoples Child & Family Review, 8(1):  93-106. (Free full-text here)

Wodinski, L., Wanke, M.I. and Khan, F. (2013). Impact Evaluation of the H.E.R. Pregnancy Program – Final Summary Report. Prepared by Charis Management Consulting for the Alberta Centre for Child, Family and Community Research.

Wodinski L & Wanke M I. (2013). Impact evaluation of the H.E.R. Pregnancy Program – Photovoice Final Report. Prepared by Charis Management Consulting Inc. (Charis) for the Alberta Centre for Child, Family and Community Research.

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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