Digital cognitive behavioral therapy (dCBT) for anxiety during pregnancy: evaluation and actioning through HOPE
Laura Jelliffe-Pawlowski
UCSF, Department of Epidemiology & Biostatistics
Jennifer Felder
UCSF, Department of Psychiatry
Karen Tabb Dina
University of Illinois, School of Social Work
Bridgette Blebu, UCLA
Kacie Blackman, CalState Northridge
Larry Rand, UCSF
Elizabeth Rogers, UCSF
Chuck McCulloch, UCSF
Clinical anxiety is associated with symptoms like difficulty controlling worries, restlessness, and irritability. Clinical anxiety is common during pregnancy and is associated with an increased risk for problems like high blood pressure or having a baby who is underweight or born prematurely. Rates of clinical anxiety are higher in some “marginalized” groups who are more likely to be subjected to social discrimination and racism (Black, Brown, Indigenous, Asian and Pacific Islander, and LGBTQ+ people). Rates are also often higher in people with lower levels of income. A type of therapy called “cognitive behavioral therapy” (CBT), which focuses on managing ways of thinking around anxiety and worries, has been shown to help reduce symptoms in some pregnant people. Digital CBT (dCBT) tools which are used online and/or on a digital device, often without a live therapist, have been shown to be helpful for reducing anxiety in some pregnant people but have not been evaluated in marginalized or low-income groups.
Our project tests whether the use of a dCBT tool would help reduce symptoms of anxiety in marginalized and low-income pregnant people in California. Conversation (focus) groups would also be conducted to determine dCBT users in the study found the tool helpful. Policy makers, health providers, and other community partners will also participate in focus groups to identify factors they think might help or hurt the possibility of dCBT being made more widely available to pregnant MediCal participants with clinical anxiety.
If the study finds that dCBT helps reduce anxiety symptoms and is acceptable to marginalized and low-income pregnant people in California, its use could represent an additional route for treating clinical anxiety in these populations. This could help improve the well-being of people in these groups and their birth outcomes.
Collaborators:
- UCLA
- Cal State Northridge
- University of Illinois
- Postpartum Support International
- 20/20 Mom
- i.D.R.E.A.M for Racial Health Equity