Treating Maternal Mental Health Problems with an App-Based Program: A Randomized Control Trial of BEAM, for Mothers of Young Children

Abstract

Importance: Exposure to maternal mental illness in the first 3 years of life is associated with poor child outcomes. Maternal mental health problems increased dramatically during the COVID-19 pandemic with many parents not having access to evidence-based treatments. Mobile health (mHealth) treatments show promise for adult mood and anxiety disorders but rarely include parenting strategies and have high dropout rates. Objective: This study aimed to evaluate the efficacy of the Building Emotion Awareness and Mental Health (BEAM) app-based program, which responds to maternal mental health and parenting needs while building social connection between participants. Design: A two-arm, phase III randomized controlled trial (RCT) was conducted to evaluate the BEAM intervention compared to unrestricted services-as-usual (US). Participants completed self-report measures at eligibility screening (baseline assessment, T0), prior to randomization (pre-intervention, T1) and immediately following the intervention (post-intervention, T2). Setting: Individuals were recruited and completed surveys online. Participants: A final sample of 119 mothers with children aged 18 to 36 months, who self-reported moderate-to-severe symptoms of depression and/or anxiety. Intervention: Individuals randomized to treatment participated in the 10-week BEAM program. It was hypothesized that the treatment group would report decreases in mental health symptoms (anxiety, depression, anger, alcohol use, sleep problems) and harsh parenting (overreactive parenting, conflictual parent-child interactions) compared to the US group. Results: BEAM out-performed the US condition in reducing anxiety symptoms. Participants in both groups experienced significant decreases in depression. Participants with higher levels of anxiety and depression symptoms at screening, experienced significant decreases in mental health symptoms and harsh parenting composite scores, if they received the BEAM program, compared to US. This included specific declines in anxiety, anger, and dysfunctional parenting interactions. There were no significant effects for sleep problems, alcohol misuse, or overactive discipline. Conclusion and Relevance: BEAM is a highly scalable intervention that has the potential to rapidly reach underserved groups in need of mental health and parenting support. Next steps include improving the user interface and exploring engagement and implementation of the program within existing health and social service systems for long-term improvements in family health and well-being