Implementation of depression screening in antenatal clinics through tablet computers: results of a feasibility study

BMC Medical Informatics and Decision Making

Research Article

Ajay K. Gupta¹  John O’Donoghue²  Josip Car²  José S. Marcano-Belisario²  Cecily Morrison²  Paul Ramchandani³ 

[1] Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK;Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK;The Centre for Pyschiatry, Department of Medicine, Imperial College London, London, UK;

关键词: Antenatal depression;    Mental health;    Edinburgh Postnatal Depression Scale (EPDS);    Whooley questions;    Population screening;    Patient self-report;    Mobile health (mHealth);    Apple ® iPad®;    Tablet computers;    Survey layout;   

DOI  :  10.1186/s12911-017-0459-8

 received in 2016-12-18, accepted in 2017-05-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMobile devices may facilitate depression screening in the waiting area of antenatal clinics. This can present implementation challenges, of which we focused on survey layout and technology deployment.MethodsWe assessed the feasibility of using tablet computers to administer a socio-demographic survey, the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to 530 pregnant women attending National Health Service (NHS) antenatal clinics across England. We randomised participants to one of two layout versions of these surveys: (i) a scrolling layout where each survey was presented on a single screen; or (ii) a paging layout where only one question appeared on the screen at any given time.ResultsOverall, 85.10% of eligible pregnant women agreed to take part. Of these, 90.95% completed the study procedures. Approximately 23% of participants answered Yes to at least one Whooley question, and approximately 13% of them scored 10 points of more on the EPDS. We observed no association between survey layout and the responses given to the Whooley questions, the median EPDS scores, the number of participants at increased risk of self-harm, and the number of participants asking for technical assistance. However, we observed a difference in the number of participants at each EPDS scoring interval (p = 0.008), which provide an indication of a woman’s risk of depression. A scrolling layout resulted in faster completion times (median = 4 min 46 s) than a paging layout (median = 5 min 33 s) (p = 0.024). However, the clinical significance of this difference (47.5 s) is yet to be determined.ConclusionsTablet computers can be used for depression screening in the waiting area of antenatal clinics. This requires the careful consideration of clinical workflows, and technology-related issues such as connectivity and security. An association between survey layout and EPDS scoring intervals needs to be explored further to determine if it corresponds to a survey layout effect. Future research needs to evaluate the effect of this type of antenatal depression screening on clinical outcomes and clinic workflows.Trial registrationThis study was registered in ClinicalTrials.gov under the identifier NCT02516982 on 20 July 2015.

【 授权许可】

CC BY   
© The Author(s). 2017