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Title: Using smartphone-based psychoeducation to reduce postnatal depression among first-time mothers : randomized controlled trial
Authors: Chan, KL 
Leung, WC
Tiwari, A
Or, KL
Ip, P
Keywords: Smartphone technology
Postnatal depression
Randomized controlled trial
Issue Date: May-2019
Publisher: JMIR Publications, Inc.
Source: JMIR mHealth and uHealth, May 2019, v. 7, no. 5, e12794, p. 1-11 How to cite?
Journal: JMIR mHealth and uHealth 
Abstract: Background: Smartphone-based psychoeducation interventions may be a low-cost, user-friendly alternative to resource-consuming, face-to-face antenatal classes to educate expectant mothers.
Objective: This study aimed to empirically examine whether such an intervention would lead to reduced postnatal depression, anxiety, or stress and result in a better health-related quality of life.
Methods: A single-blind randomized controlled trial was conducted in Hong Kong. All first-time expectant mothers with less than 24 weeks of gestation remaining and attending the antenatal clinic at a public hospital were included. Participants were assigned to the intervention group or the control group by drawing lots. The lots, presented in sealed opaque envelopes, were randomly designated as “intervention” or “control” by stratified randomization. The intervention, a psychoeducational mobile app, was provided in addition to the treatment as usual (TAU) services from the hospital. Follow up with participants took place at 4 weeks postpartum. The primary outcome was the difference in the levels of antenatal and postnatal depression, assessed by the Edinburgh Postnatal Depression Scale (EPDS). The intention-to-treat approach was employed in the analyses.
Results: The final sample was 660 expectant mothers (nintervention=330 and ncontrol=330). The mean difference in EPDS scores between the two groups was −0.65 (95% CI −1.29 to 0.00; P=.049) after adjusting for confounding factors. Associations were found between participation in the intervention and reduced depression, and attendance in TAU classes and increased stress levels.
Conclusions: The smartphone-based intervention plus TAU services was effective in reducing postnatal depression at 4 weeks postpartum compared with a control condition of TAU only, making this a cost-effective alternative to TAU education for expectant mothers. Limitations of the study included the short postpartum period after which the follow-up assessment was conducted and the inclusion of first-time mothers rather than all mothers.
EISSN: 2291-5222
DOI: 10.2196/12794
Rights: ©Ko Ling Chan, Wing Cheong Leung, Agnes Tiwari, Ka Lun Or, Patrick Ip. Originally published in JMIR Mhealth and Uhealth (, 12.05.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
The following publication Chan, K. L., Leung, W. C., Tiwari, A., Or, K. L. & Ip, P. (2019). Using smartphone-based psychoeducation to reduce postnatal depression among first-time mothers: randomized controlled trial. JMIR Mhealth Uhealth, 7(5), e12794, 1-11 is available at
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