Ayesha Mae Bilal

BACKGROUND Mobile research apps are increasingly used in mental health studies to enable multimodal data collection, including self-report, passive smartphone data, and digital behavioral assessments. However, ensuring usability and sustained engagement remains a challenge. User expectations, shaped by commercial apps, often conflict with research constraints, making it difficult to design research-driven apps that balance usability with scientific rigor. Applying user-centered design (UCD) principles can help address these challenges, but their role in optimizing research apps, especially those used in studies involving varied data protocols, requires further evaluation. OBJECTIVE This study aimed to document the UCD process used in developing a mobile research app for young people’s mental health (the UPIC app), assess its usability post-implementation, and provide insights for future research app developers and study designers. METHODS A UCD approach was applied, involving a series of design workshops with young people aged 15–29 to co-design the app’s interface, including early drafts of visual layout and wording. Iterative design modifications were made based on participant feedback. Following development, a usability test was conducted with 10 participants using iOS and Android devices. Participants completed task-based usability evaluations while using the think-aloud method, followed by semi-structured interviews, and the User Experience Plus (UEQ+) questionnaire. Qualitative data were analyzed using qualitative content analysis; quantitative data focused on task performance metrics and user experience scores. RESULTS User involvement contributed to improvements in interface aesthetics, navigation, accessibility, and clarity of wording. Usability testing identified remaining issues related to system feedback, survey tracking, and interaction clarity. Some user- suggested features, such as enhanced survey progress tracking and engagement elements, were only partially implemented due to feasibility constraints and concerns about data integrity. Participants evaluated the app positively in terms of trustworthiness and ease of learning, as reflected in UEQ+ scores, while ratings for engagement and novelty were lower. CONCLUSIONS While UCD improved interface usability, findings highlight the importance of combining user involvement with early, real-world usability testing to identify persistent issues. Balancing usability best practices with research constraints requires transparent communication of study design, ethical engagement strategies, and structured usability evaluations. Future research app development studies should integrate iterative UCD to support both user experience and data quality. CLINICALTRIAL ClinicalTrials.gov (UU20230127; NCT: NCT06490120)

Background: Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users’ perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user’s concerns and the challenges they experience using the app will facilitate adoption and continued engagement. Objective: This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app. Methods: Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis. Results: Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience. Conclusions: The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

BACKGROUND Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users’ perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user’s concerns and the challenges they experience using the app will facilitate adoption and continued engagement. OBJECTIVE This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app. METHODS Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis. RESULTS Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience. CONCLUSIONS The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

Antenatal depression impacts 7-20% of women globally, and can have serious consequences for both the mother and the infant. Preventative interventions are effective, but are cost-efficient only among those at high risk. As such, being able to predict and identify those at risk is invaluable for reducing the burden of care and adverse consequences, as well as improving treatment outcomes. While several approaches have been proposed in the literature for the automatic prediction of depressive states, there is a scarcity of research on automatic prediction of perinatal depression. Moreover, while there exist some works on the automatic prediction of postpartum depression using data collected in clinical settings and applied the model to a smartphone application, to the best of our knowledge, no previous work has investigated the automatic prediction of late antenatal depression using data collected via a smartphone app in the first and second trimesters of pregnancy. This study utilizes data measuring various aspects of self-reported psychological, physiological and behavioral information, collected from 915 women in the first and second trimester of pregnancy using a smartphone app designed for perinatal depression. By applying machine learning algorithms on these data, this paper explores the possibility of automatic early detection of antenatal depression (i.e., during week 36 to week 42 of pregnancy) in everyday life without the administration of healthcare professionals. We compare uni-modal and multi-modal models and identify predictive markers related to antenatal depression. With multi-modal approach the model reaches a BAC of 0.75, and an AUC of 0.82.

Introduction Perinatal complications, such as perinatal depression and preterm birth, are major causes of morbidity and mortality for the mother and the child. Prediction of high risk can allow for early delivery of existing interventions for prevention. This ongoing study aims to use digital phenotyping data from the Mom2B smartphone application to develop models to predict women at high risk for mental and somatic complications. Methods and analysis All Swedish-speaking women over 18 years, who are either pregnant or within 3 months postpartum are eligible to participate by downloading the Mom2B smartphone app. We aim to recruit at least 5000 participants with completed outcome measures. Throughout the pregnancy and within the first year postpartum, both active and passive data are collected via the app in an effort to establish a participant’s digital phenotype. Active data collection consists of surveys related to participant background information, mental and physical health, lifestyle, and social circumstances, as well as voice recordings. Participants’ general smartphone activity, geographical movement patterns, social media activity and cognitive patterns can be estimated through passive data collection from smartphone sensors and activity logs. The outcomes will be measured using surveys, such as the Edinburgh Postnatal Depression Scale, and through linkage to national registers, from where information on registered clinical diagnoses and received care, including prescribed medication, can be obtained. Advanced machine learning and deep learning techniques will be applied to these multimodal data in order to develop accurate algorithms for the prediction of perinatal depression and preterm birth. In this way, earlier intervention may be possible. Ethics and dissemination Ethical approval has been obtained from the Swedish Ethical Review Authority (dnr: 2019/01170, with amendments), and the project fully fulfils the General Data Protection Regulation (GDPR) requirements. All participants provide consent to participate and can withdraw their participation at any time. Results from this project will be disseminated in international peer-reviewed journals and presented in relevant conferences.