Understanding needs and perspectives on remote technological interventions for perinatal mood and anxiety disorders: experiences of Black or African American women (Preprint)

BACKGROUND Perinatal mood and anxiety disorders (PMADs) affect one in four women, contributing to maternal health complications and adversely affecting child development outcomes. While remote intervention systems can increase care access, lower costs, and reduce stigma, most are limited to either the pregnancy or postpartum phase—failing to provide continuous support across the entire perinatal period. Moreover, these systems are rarely designed with the specific cultural, social, and structural needs of racial and ethnic minority women, who face disproportionate barriers to mental health care. Given the evolving and complex nature of mental health challenges before and after childbirth, there is an urgent need for a remote intervention system that delivers effective, inclusive support throughout all phases of the perinatal journey. OBJECTIVE This study aims to: 1) identify the challenges and needs of Black or African American women experiencing PMAD; 2) explore the benefits and barriers influencing their willingness to use remote intervention systems; and 3) determine essential features for such a system. METHODS A mixed-methods approach was used, combining an online survey with semi-structured interviews from perinatal women who identify as Black or African American. The survey assessed mental health challenges, support preferences (in-person, remote, or both), and desired intervention features, with chi-square and ANOVA tests performed for quantitative analysis. Follow-up Zoom interviews were conducted, and responses were analyzed using thematic coding. RESULTS While frequency of PMAD was not significant across the perinatal phases, a majority of support was sought during the second and third trimesters, suggesting the need for targeted interventions during these phases. Participants identified four key challenges: emotional, physical, financial, systemic and social barriers to support. The preference for remote or hybrid (in-person and remote) support was high during the second (72.4%) and third trimesters (79.2%). Major benefits of remote systems included easier appointment scheduling (90.3%), reduced travel time (90.3%), and lower costs (80.6%). However, primary barriers were missing in-person interaction (64.5%), and time constraints due to family responsibilities (67.7%). Key features preferred for remote systems included: communication with healthcare providers, cognitive behavioral therapy-based counseling services, symptom monitoring for anxiety or depression, calming music, positive affirmations or motivational quotes, and educational resources. Participants favored a customizable smartphone-based system, with sessions requiring minimal time commitment between 15-60 minutes, and flexible scheduling particularly during the postpartum period. CONCLUSIONS Findings suggest that mental health intervention systems for Black or African American women should primarily focus on the second and third trimesters, as participants seek more support in these phases. Further the interventions should be holistic, incorporating physical health tracking, emotional well-being tools, and education tools.