Abstract
Background: Passive sensor data from mobile devices can shed light on daily activities, social behavior, and maternal-child interactions to improve maternal and child health services including mental healthcare. We assessed feasibility and acceptability of the Sensing Technologies for Maternal Depression Treatment in Low Resource Settings (StandStrong) platform. The StandStrong passive data collection was piloted with adolescent and young mothers, including mothers experiencing postpartum depression, in Nepal.Methods: Mothers (15-25 years old) with infants (<12 months old) were recruited in person from vaccination clinics in rural Nepal. They were provided with an Android smartphone and a Bluetooth beacon to collect data in four domains: the mother’s location using the Global Positioning System (GPS), physical activity using the phone’s accelerometer, auditory environment using episodic audio recording on the phone, and mother-infant proximity measured with the Bluetooth beacon attached to the infant’s clothing. Feasibility and acceptability were evaluated based on the amount of passive sensing data collected compared to the total amount that could be collected in a 2-week period. Endline qualitative interviews (n=31) were conducted to understand mothers’ experiences and perceptions of passive data collection. Results: 782 women were approached and 320 met eligibility criteria. 38 mothers (11 depressed, 27 non-depressed) were enrolled. Of 9,605 possible readings per sensor, 5,579 audio recordings [mean (M)=57.4%; median (Mdn)=62.6%], 5,001 activity readings (M=50.6%; Mdn=63.2%), 4,168 proximity readings (M=41.1%; Mdn=47.6%), and 3,482 GPS readings (M=35.4%; Mdn=39.2%) were obtained. Feasibility challenges were phone battery charging, data usage exceeding pre-paid limits, and burden of carrying mobile phones. Acceptability challenges were privacy concerns and lack of family involvement. Overall, families’ understanding of passive sensing and families’ awareness of potential benefits to mothers and infants were the major modifiable factors to increase acceptability and reduce gaps in data collection. Conclusion: Approximately half of all possible passive data readings were collected. Feasibility challenges can be addressed by providing alternative phone charging options, setting up reverse billing for the app, and exploring smartwatches as a replacement for mobile phones. Enhancing acceptability will require greater family involvement and improved communication regarding benefits of passive sensing for psychological interventions and other health services. Registration: International Registered Report Identifier (IRRID): DERR1-10.2196/14734
Tuberculosis: an opportunity to integrate mental health services in primary care in low-resource settings
