Does the use of a mindfulness app combined with peer support improve pregnant women's mental health?

An exploratory sequential mixed method design consisting of two phases will be used in the study. In the first phase, focus groups or one-to-one interviews will be conducted by midwife researchers to explore pregnant women's experiences related to support groups and mindfulness. The ideal sample size for the focus groups or interviews will be between five and eight pregnant women. The interview questions will be focused specifically on combined peer support and mindfulness-based approach: asking their suggestions about the strategies and activities, their particular likes/dislikes, and what the most important features of a peer support program are. Findings from phase one will inform the design and structure of the intervention in phase two. Phase two will involve a pilot study that utilizes a quasi-experimental design. Intervention: phase two will be a peer support group combined with mindfulness app as an intervention for pregnant women with anxiety and depression. Peer support groups aim to bring women together for mutual support and use of the mindfulness-based app (Headspace) activity together. The facilitators (researchers) will hold a joint peer support group with a mindfulness-based approach for four weeks each session will last for about one-hour duration. A hybrid meeting option (in-person or online) will be provided. Peer support will be offered through the general discussion of listening, acknowledging, and sharing of strategies to maintain a positive outlook. The group sessions will be designed according to recommended activities derived from the findings of study phase one which explore women’s knowledge, experiences and perceptions about peer support combined with a mindfulness-based approach to support perinatal mental health. The intervention will consist of four group sessions: 1) Introduction to the program and focusing on one’s personal health and well-being; 2) Ideas related to physical and emotional common discomforts of pregnancy; 3) Increasing helpful thoughts that affect my baby and myself; 4) Transition to motherhood and community and mindfulness-based resources. (The topics vary weekly and could be adjusted based on results from phase one of the study). Following the topic discussion participants will engage in 10 minutes of mindfulness activities through the Headspace App. The mindfulness session content will include (a) practicing mindfulness meditation and coping strategies, (b) using mindfulness to connect with their babies, (c) understanding stress and how to prepare for unexpected moments during new parenthood. The approximate size of the mindfulness app and the peer support group session will be six pregnant women. There will be a total of four sessions, to be held weekly for four weeks and using session attendance checklists to monitor adherence to the intervention.