{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:07:32Z","timestamp":1784290052754,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P50MH119029"],"award-info":[{"award-number":["P50MH119029"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Perinatal mental health conditions are common yet frequently undertreated. Perinatal collaborative care models improve access to evidence\u2010based care but face implementation challenges related to workflow efficiency and scalability. Digital innovations may enhance care delivery and sustainability within perinatal collaborative care models. This study evaluated whether a technology\u2010enabled service, designed to support and streamline care manager workflow in a perinatal collaborative care model, improves depression and anxiety symptoms, patient satisfaction, and engagement compared with the collaborative care model without digital support tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial was conducted from October 2022 through January 2024 within a perinatal collaborative care program serving five obstetric clinics in Chicago, Illinois. Participants included 75 pregnant or postpartum individuals enrolled in collaborative care with symptoms of depression (Patient Health Questionnaire\u20109 [PHQ\u20109] \u2265 5) or anxiety (Generalized Anxiety Disorder\u20107 [GAD\u20107] \u2265 5). Participants were randomized either to a technology\u2010enabled service incorporating a cognitive behavioral therapy mobile application with text\u2010based coaching and a care manager\u2013facing dashboard or to usual perinatal collaborative care without digital tools. Depression and anxiety symptoms were assessed biweekly for 12\u00a0weeks using the PHQ\u20109 and GAD\u20107. Score results were analyzed using generalized linear mixed models. Additional outcomes included symptom response (\u226550% reduction from baseline), symptom remission (PHQ\u20109 and GAD\u20107\u00a0&lt;\u00a05), stepped care utilization, patient satisfaction, and engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 75 individuals were enrolled with 38 randomized to the technology\u2010enabled service. Depression (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.24; 95% CI, \u22120.45 to \u22120.03) and anxiety (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.24; 95% CI, \u22120.46 to \u22120.03) symptoms improved over time in both groups. There were no significant differences between the technology\u2010enabled service and usual care groups for depression (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.06; 95% CI, \u22120.06 to 0.17) or anxiety (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.06; 95% CI, \u22120.30 to 0.19). Response and remission rates did not differ between groups for depression (43%\u00a0vs. 53%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.4; 46%\u00a0vs. 32%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.2) or anxiety (35%\u00a0vs. 55%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.08; 32%\u00a0vs. 32%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.9). Stepped care occurred in 21% of participants in the technology\u2010enabled service group and 20% in the usual care group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.9). Engagement at the study midpoint was higher in the technology\u2010enabled service group, while satisfaction was comparable across groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although symptom improvement was similar between groups, the technology\u2010enabled service improved patient engagement within perinatal collaborative care. These findings suggest that while digital tools may not directly benefit clinical care, they may enhance operational efficiency and support the scalability and sustainability of perinatal collaborative care models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT05525689<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70298","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:42:26Z","timestamp":1777902146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A technology\u2010enabled service for perinatal collaborative care models: A randomized clinical trial"],"prefix":"10.1002","volume":"2","author":[{"given":"Emily S.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Maternal\u2010Fetal Medicine Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Mohr","sequence":"additional","affiliation":[{"name":"Departments of Preventive Medicine Psychiatry, and Medical Social Sciences Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinah","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Women &amp; Infants Hospital of Rhode Island  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Shikany","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan W.","family":"Winquist","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Division of Biostatistics and Informatics Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Krause","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-2325","authenticated-orcid":false,"given":"Lara M.","family":"Baez","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu C.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Informatics University of California Irvine Donald Bren School of Information and Computer Sciences  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"1998","volume-title":"AHRQ Evidence Report Summaries","author":"Gaynes B. N.","year":"2005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.87"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000001695"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp15X686377"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(14)61277\u20100"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005202"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005200"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00171-6"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2008.10.002"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2013.09.002"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006525.pub2"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.01.019"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2005.10.008"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115514-201003000-00006"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181dbea62"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181e5792b"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674371205700305"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp17X692549"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22405"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000231"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20108\u2010135"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1842"},{"key":"e_1_2_10_24_1","volume-title":"Americans\u2019 Internet Access: 2000\u20132015","author":"Perrin A.","year":"2015"},{"key":"e_1_2_10_25_1","unstructured":"Smith A.2015.U.S. Smartphone Use in 2015.Washington DC:Pew Research Center.http:\/\/www.pewinternet.org\/2015\/04\/01\/us\u2010smartphone\u2010use\u2010in\u20102015\/."},{"key":"e_1_2_10_26_1","unstructured":"Poushter J.2016.Smartphone Ownership and Internet Usage Continues to Climb in Emerging Economies.Washington DC:Pew Research Center."},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000563"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.1011"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.2196\/13609"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6645"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2018.1457079"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0165\u20101781(97)00122\u20104"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.2196\/17757"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000003369"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2023.05.007"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.120272"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.2196\/24387"}],"container-title":["Pregnancy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmf2.70298","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:51:14Z","timestamp":1784289074000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pmf2.70298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/pmf2.70298"],"URL":"https:\/\/doi.org\/10.1002\/pmf2.70298","archive":["Portico"],"relation":{},"ISSN":["2997-9684","2997-9684"],"issn-type":[{"value":"2997-9684","type":"print"},{"value":"2997-9684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70298"}}