{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:19:07Z","timestamp":1787797147706,"version":"build-2784847793"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Underserved women experience disproportionately high rates of perinatal mental health (PMH) difficulties but face substantial barriers to accessing appropriate care. Evidence on how services can be redesigned to improve equitable access remains limited. The Perinatal Redesign for Accessing Mental Health Services (PRAMS) study aimed to co\u2010produce an intervention to improve access to PMH support for underserved women and birthing people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PRAMS is a mixed\u2010methods study informed by Accelerated Experience\u2010Based Co\u2010Design and the Medical Research Council framework for complex intervention development. This paper reports findings from Work Packages 1 and 2. Work Package 1 included a national survey of professionals (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009129) and semi\u2010structured interviews (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) exploring service provision and barriers to care. Work Package 2 involved 10 focus groups and 4 interviews with underserved women and birthing people (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) recruited through Community Research Link Workers with lived experience. Data were analysed using framework analysis guided by the Candidacy Framework.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Barriers to PMH care were identified across all domains of candidacy. Structural barriers included fragmented services, unclear referral pathways, and limited resources. Cultural stigma, language barriers and fears regarding child protection services limited help\u2010seeking. Trust, continuity of care and community\u2010based services facilitated engagement. Both professionals and women described a mismatch between rigid service models and women's preferences for relational, flexible and culturally responsive support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Access to PMH care among underserved populations is shaped by complex structural and relational factors. Findings highlight the need for flexible, community\u2010based and relationship\u2010centred models of care. Co\u2010production with underserved communities offers a promising approach for developing equitable PMH services to better meet the needs of women facing multiple vulnerabilities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70766","type":"journal-article","created":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T16:24:04Z","timestamp":1783873444000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co\u2010Producing Equitable Perinatal Mental Health Care: Facilitators and Barriers to Access Among Underserved Women in the PRAMS Study"],"prefix":"10.1111","volume":"29","author":[{"given":"Elena","family":"Sheldon","sequence":"first","affiliation":[{"name":"Sheffield Health Partnership University NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-1108","authenticated-orcid":false,"given":"Naseeb","family":"Ezaydi","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health The University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Hahn","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health The University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Sheffield Health Partnership University NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Ahmed","sequence":"additional","affiliation":[{"name":"LIGHT Peer Support Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Miles","sequence":"additional","affiliation":[{"name":"LIGHT Peer Support Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Thompson","sequence":"additional","affiliation":[{"name":"Public Health, Sheffield City Council Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Marvin\u2010Dowle","sequence":"additional","affiliation":[{"name":"Public Health, Doncaster Council Doncaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-0679","authenticated-orcid":false,"given":"Kate","family":"Fryer","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health The University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sutton","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health The University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6754-7129","authenticated-orcid":false,"given":"Victoria","family":"Silverwood","sequence":"additional","affiliation":[{"name":"School of Medicine Keele University Keele UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Mitchell","sequence":"additional","affiliation":[{"name":"School of Medicine Keele University Keele UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hind","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health The University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2013.09.002"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00254_3.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171600283X"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.12.005"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.183.4.279"},{"key":"e_1_2_12_7_1","unstructured":"World Health Organization. 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