CHI 2023: Digital Mental Health Resources Not Meeting Perinatal Black Women's Needs

Pregnant and postpartum Black women experience disproportionately higher rates of mental health challenges, and new research indicates that a one-size-fits-all approach to digital mental health tools and platforms is falling short for these women.

Vanessa Oguamanam has researched the correlation of digital tools and how often Black women in perinatal stages use them to improve their mental health.

According to the Anxiety and Depression Association of America, Black women are at “higher risk for experiencing perinatal and postnatal anxiety disorders such as depression, anxiety, obsessive compulsive disorder, and posttraumatic stress disorder." The risk for PMADs is estimated to be double that of the general population.

[MICROSITE: Georgia Tech at CHI 2023]

The problem has worsened since the Covid-19 pandemic, says Oguamanam, a Ph.D. student in the School of Interactive Computing under the advisement of Associate Professor Andrea Parker, founder and director of the Wellness Technology Research Lab. Oguamanam has spent most of her doctoral career researching technology designed to benefit the health of Black women.

“I had friends who became new moms during the pandemic and just seeing the extra amount of stress that they were enduring in addition to balancing new childcare responsibilities led me to start thinking of potential ways I could address this mental health crisis with technology.” she said.

“Mental health is one of the leading complications during pregnancy and childbirth, and it’s a contributing factor to some maternal deaths. The pandemic exacerbated all of that. We’re seeing rates that are skyrocketing.”

In a paper that was accepted at the 2023 Conference on Human Factors in Computing Systems (CHI), Oguamanam and Parker surveyed 101 pregnant and postpartum Black women. They found 34% reported moderate to severe anxiety, while 41% percent expressed having moderate to severe psychological distress, and 74% experienced a high level of postnatal depressive symptoms.

Oguamanam and Parker also studied participant interaction with four main forms of technology — social media, apps, self-tracking devices, and video calls.

“There’s been very little work investigating how we can design digital mental health tools to support Black pregnant and postpartum women’s needs,” Parker said. “We’re trying to understand what their current use and satisfaction level is with existing platforms. We need this foundational understanding to drive future design efforts.”

The research indicates that income and education levels were significant variables among the women surveyed. Of the 101 participants surveyed, 49 identified as low income, and 43 percent identified as middle to upper income. Forty-three held less than a bachelor’s degree while 58 held a bachelor’s degree or higher.

Those with higher incomes and education tended to use apps and self-tracking devices more frequently. The use of video calls varied among pregnancy status and the area of the U.S. where participants lived. Women who were pregnant and lived in the South used video calls most frequently.

Social media was widely used among all demographics.

One of the main takeaways from the study is that participant feedback shows the “one-size-fits-all” approach that digital mental health interventionists often take in their design methods can be insufficient for meeting the needs of pregnant and postpartum Black women. Oguamanam said the societal problems of systemic racism and barriers to healthcare that Black women experience aren’t often considered in such efforts.

“Years and years of experiencing racial and gendered discrimination have impacted the stress levels of Black women and their overall well-being,” she said.

“It’s important to emphasize that when we’re thinking about health disparities among racial groups, there can be a tendency to think it just boils down to differences in socioeconomic status,” echoed Parker. “But many of these disparities persist when we compare higher income groups of black women to another racial ethnic group. These inequitable differences reflect a broader set of structural forces that create barriers to healthcare access and quality and increased exposure to mental health threats.”

Oguamanam and Parker also found that 97% of the women surveyed embraced the identity of the strong Black woman, a representation that has been explored at length by social science researchers.

Researchers agree the external factors of systemic racism and healthcare barriers tend to push Black women toward that identity.

“It’s a role that a number of Black women tend to identify with, either consciously or subconsciously,” Oguamanam said. “It’s the idea of presenting an image of strength and feeling like you have to take care of you, your family, and your community and that you’re responsible for carrying the weight of the world on your shoulders.”

Oguamanam’s and Parker’s study indicates women with greater adoption of the strong Black woman persona tended to use self-tracking devices with greater frequency. That trend could be attributable to those devices offering a sense of autonomy, Parker said.

“The whole vision of self-tracking devices is that you can take care of yourself,” Parker said. “You can monitor your own well-being and oversee collecting data and managing your own health. That type of platform might be more appealing to individuals who have a resistance toward being vulnerable.”

These findings only scratch the surface, and Oguamanam and Parker hope to shift current methods and discussions surrounding digital mental health toward a more inclusive environment that includes the experience of pregnant and postpartum Black women.

“More research is needed to investigate these hypotheses, and ultimately design and demonstrate the effectiveness of digital tools that support the wellbeing of pregnant and postpartum Black women,” Parker said. “Such innovations can help us make necessary strides toward achieving maternal mental health equity.”