TY - JOUR
AU - E. S. Miller
AU - D. C. Mohr
AU - D. Williams
AU - M. Shikany
AU - T. Walsh
AU - N. W. Winquist
AU - Z. Mir
AU - E. L. Gray
AU - S. R. Smith
AU - C. Krause
AU - L. M. Baez
AU - M. C. Reddy
A1 - 
AB - INTRODUCTION: Perinatal mental health conditions are common yet frequently undertreated. Perinatal collaborative care models improve access to evidence-based care but face implementation challenges related to workflow efficiency and scalability. Digital innovations may enhance care delivery and sustainability within perinatal collaborative care models. This study evaluated whether a technology-enabled service, designed to support and streamline care manager workflow in a perinatal collaborative care model, improves depression and anxiety symptoms, patient satisfaction, and engagement compared with the collaborative care model without digital support tools. METHODS: This randomized controlled trial was conducted from October 2022 through January 2024 within a perinatal collaborative care program serving five obstetric clinics in Chicago, Illinois. Participants included 75 pregnant or postpartum individuals enrolled in collaborative care with symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] ≥ 5) or anxiety (Generalized Anxiety Disorder-7 [GAD-7] ≥ 5). Participants were randomized either to a technology-enabled service incorporating a cognitive behavioral therapy mobile application with text-based coaching and a care manager-facing dashboard or to usual perinatal collaborative care without digital tools. Depression and anxiety symptoms were assessed biweekly for 12 weeks using the PHQ-9 and GAD-7. Score results were analyzed using generalized linear mixed models. Additional outcomes included symptom response (≥50% reduction from baseline), symptom remission (PHQ-9 and GAD-7 < 5), stepped care utilization, patient satisfaction, and engagement. RESULTS: A total of 75 individuals were enrolled with 38 randomized to the technology-enabled service. Depression (β = -0.24; 95% CI, -0.45 to -0.03) and anxiety (β = -0.24; 95% CI, -0.46 to -0.03) symptoms improved over time in both groups. There were no significant differences between the technology-enabled service and usual care groups for depression (β = -0.06; 95% CI, -0.06 to 0.17) or anxiety (β = -0.06; 95% CI, -0.30 to 0.19). Response and remission rates did not differ between groups for depression (43% vs. 53%, p = 0.4; 46% vs. 32%, p = 0.2) or anxiety (35% vs. 55%, p = 0.08; 32% vs. 32%, p = 0.9). Stepped care occurred in 21% of participants in the technology-enabled service group and 20% in the usual care group (p > 0.9). Engagement at the study midpoint was higher in the technology-enabled service group, while satisfaction was comparable across groups. CONCLUSIONS: Although symptom improvement was similar between groups, the technology-enabled service improved patient engagement within perinatal collaborative care. These findings suggest that while digital tools may not directly benefit clinical care, they may enhance operational efficiency and support the scalability and sustainability of perinatal collaborative care models. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05525689.
AD - Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine Alpert Medical School of Brown University Providence Rhode Island USA.; Departments of Preventive Medicine Psychiatry, and Medical Social Sciences Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Obstetrics and Gynecology Women & Infants Hospital of Rhode Island Providence Rhode Island USA.; Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Preventive Medicine Division of Biostatistics and Informatics Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Informatics University of California Irvine Donald Bren School of Information and Computer Sciences Irvine California USA.
AN - 42597011
BT - Pregnancy (Hoboken)
C5 - HIT & Telehealth; Healthcare Disparities
CP - 3
DA - 05/2026
DO - 10.1002/pmf2.70298
DP - NLM
ET - 20260504
IS - 3
JF - Pregnancy (Hoboken)
LA - eng
N2 - INTRODUCTION: Perinatal mental health conditions are common yet frequently undertreated. Perinatal collaborative care models improve access to evidence-based care but face implementation challenges related to workflow efficiency and scalability. Digital innovations may enhance care delivery and sustainability within perinatal collaborative care models. This study evaluated whether a technology-enabled service, designed to support and streamline care manager workflow in a perinatal collaborative care model, improves depression and anxiety symptoms, patient satisfaction, and engagement compared with the collaborative care model without digital support tools. METHODS: This randomized controlled trial was conducted from October 2022 through January 2024 within a perinatal collaborative care program serving five obstetric clinics in Chicago, Illinois. Participants included 75 pregnant or postpartum individuals enrolled in collaborative care with symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] ≥ 5) or anxiety (Generalized Anxiety Disorder-7 [GAD-7] ≥ 5). Participants were randomized either to a technology-enabled service incorporating a cognitive behavioral therapy mobile application with text-based coaching and a care manager-facing dashboard or to usual perinatal collaborative care without digital tools. Depression and anxiety symptoms were assessed biweekly for 12 weeks using the PHQ-9 and GAD-7. Score results were analyzed using generalized linear mixed models. Additional outcomes included symptom response (≥50% reduction from baseline), symptom remission (PHQ-9 and GAD-7 < 5), stepped care utilization, patient satisfaction, and engagement. RESULTS: A total of 75 individuals were enrolled with 38 randomized to the technology-enabled service. Depression (β = -0.24; 95% CI, -0.45 to -0.03) and anxiety (β = -0.24; 95% CI, -0.46 to -0.03) symptoms improved over time in both groups. There were no significant differences between the technology-enabled service and usual care groups for depression (β = -0.06; 95% CI, -0.06 to 0.17) or anxiety (β = -0.06; 95% CI, -0.30 to 0.19). Response and remission rates did not differ between groups for depression (43% vs. 53%, p = 0.4; 46% vs. 32%, p = 0.2) or anxiety (35% vs. 55%, p = 0.08; 32% vs. 32%, p = 0.9). Stepped care occurred in 21% of participants in the technology-enabled service group and 20% in the usual care group (p > 0.9). Engagement at the study midpoint was higher in the technology-enabled service group, while satisfaction was comparable across groups. CONCLUSIONS: Although symptom improvement was similar between groups, the technology-enabled service improved patient engagement within perinatal collaborative care. These findings suggest that while digital tools may not directly benefit clinical care, they may enhance operational efficiency and support the scalability and sustainability of perinatal collaborative care models. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05525689.
PY - 2026
SN - 2997-9684
SP - e70298
ST - A technology-enabled service for perinatal collaborative care models: A randomized clinical trial
T1 - A technology-enabled service for perinatal collaborative care models: A randomized clinical trial
T2 - Pregnancy (Hoboken)
TI - A technology-enabled service for perinatal collaborative care models: A randomized clinical trial
U1 - HIT & Telehealth; Healthcare Disparities
U3 - 10.1002/pmf2.70298
VL - 2
VO - 2997-9684
Y1 - 2026
ER -