title: Feasibility and Perception of Using Text Messages as an Adjunct Therapy for Low-Income, Minority Mothers With Postpartum Depression.
abstract: BACKGROUND
  Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face.
  
  
  OBJECTIVE
  Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression.
  
  
  METHODS
  Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey.
  
  
  RESULTS
  In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US $777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%).
  
  
  CONCLUSIONS
  Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression.
authors.affiliation: SSM Cardinal Glennon Children's Medical Center Department of Pediatrics Saint Louis University School of Medicine St. Louis, MO United States ; Albert Gnaegi Center for Health Care Ethics Saint Louis University St. Louis, MO United States.
authors.forename: Matthew A
authors.identifier: 0000-0003-4147-2314
authors.initials: MA
authors.lastname: Broom
authors.affiliation: SSM Cardinal Glennon Children's Medical Center Department of Pediatrics Saint Louis University School of Medicine St. Louis, MO United States.
authors.forename: Amy S
authors.identifier: 0000-0001-5655-9637
authors.initials: AS
authors.lastname: Ladley
authors.affiliation: SSM Cardinal Glennon Children's Medical Center Department of Pediatrics Saint Louis University School of Medicine St. Louis, MO United States.
authors.forename: Elizabeth A
authors.identifier: 0000-0001-7878-2418
authors.initials: EA
authors.lastname: Rhyne
authors.affiliation: SSM Cardinal Glennon Children's Medical Center Department of Pediatrics Saint Louis University School of Medicine St. Louis, MO United States ; Center for Outcomes Research Saint Louis University St. Louis, MO United States.
authors.forename: Donna R
authors.identifier: 0000-0003-4202-2235
authors.initials: DR
authors.lastname: Halloran
keywords: health care disparities; mental illness; mobile health; short message service