Acceptability of remotely supervised Home-Based transcranial direct current stimulation combined with Cognitive-behavioural-based app for peripartum depression: perspectives from women with lived experience and mental health professionals

Peripartum depression (PPD) has a global prevalence of 20% significantly impacting societies. Yet, existing treatments face barriers for its uptake. This study examined the acceptability of a remotely supervised home-based transcranial direct current stimulation (tDCS) solution combined with a CBT-based app (the FLOW Neuroscience solution) for PPD, among women (experts by experience; EEs) and healthcare professionals (HPs). Fifteen EEs and 14 HPs participated in focus groups informed by the Theoretical Framework of Acceptability. Narratives were iteratively refined, using the template analysis method. Participants were overall positive about the treatment considering it supports patients' autonomy, freedom of choice and a universally accessible perinatal mental health care system. However, they also highlighted several concerns, such as the limitations of exclusively remote/virtual and bot-lead interventions which, on the one hand, may address fear of stigma about perinatal mental health, but on the other may also increase loneliness in depressed patients. Additionally, participants emphasized the need for effective communication strategies to build trust over health innovation and recommended the integration of home-based remotely supervised tDCS treatments combined with a CBT-based app into existing care models. Our findings suggest that while the FLOW solution addresses existing gaps in PPD it also presents some limitations. Here we provide user-centered actionable insights into the adjustment of this innovative, home-based solution to enhance access and engagement in PPD care.