Understanding the user experience of a web-based screening program for pregnancy specific anxiety: a qualitative descriptive study

BACKGROUND: Pregnancy-specific anxiety (PSA) is prevalent and associated with adverse perinatal outcomes. The scarcity of health care resources hinders universal screening for perinatal mental health conditions. Web-based screening programs with embedded interpretation and recommended support pathways can be a scalable and cost-effective approach to address common mental health issues. Our team created the PSA Screening Program (PSA-SP) and examined its feasibility and acceptability. The aim of this research was to understand the participants' experience with the program, explore help-seeking intentions and behaviours after screening and synthesize the participants' feedback to determine how the program can be improved. METHODS: We conducted a qualitative descriptive study with semi-structured interviews. Inclusion criteria were: age ≥ 19 years, having a singleton pregnancy, ≤ 24 weeks' gestation, living in British Columbia, Canada, and access to the Internet. Interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS: Sixteen interviews provided data and findings were classified under three themes: (1) user experience and feedback on PSA-SP, (2) cognitive and behavioral impacts of screening: risk appraisal and help seeking, and (3) experience with the overall study. Main findings of the user experience and feedback theme included a need to elaborate on the experience and individualizing the input, benefits of receiving the actual screening score, contextualizing the results and receiving feedback in each assessment. Risk appraisal included reflection and increased self-awareness, comparison with others and the extent of screening results' alignment with participants' expectations. Help-seeking after screening included sharing the results and considering/reaching out for support. Participants experiencing anxiety were heterogenous in terms of awareness of their condition and readiness to seek support after screening. CONCLUSION: Web-based screening for PSA along with signposting was acceptable to this sample of pregnant people. The detailed user feedback collected in this study can inform the enhanced design of web-based screening programs for this population.