Healthy Moms

A chatbot for perinatal depression

Most people who suffer from depression and other common mental disorders don't get treatment.

Often because they can't. In many communities, there are few (if any) providers to pay, even if you could afford the bill. More than 3 billion of us live in a country where there is only 1 psychiatrist for every 200,000 people. Psychologists are in even shorter supply.

We're exploring how artificial intelligence can be used to expand access to treatment for perinatal depression.

Our team of researchers at Duke University, service providers at Jacaranda Health in Kenya, and AI experts at X2AI are adapting an evidence-based treatment called Thinking Healthy for automated delivery via SMS in Kenya.

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Introducing the Healthy Moms companion journal for pregnant women and new moms.

The original Thinking Healthy program was designed to be delivered in-person by non-specialist health workers. More recent versions have explored in-person delivery by trained peers. Healthy Moms is different because there is no in-person component of the program. While our remote SMS model has many potential advantages in terms of scalability and sustainability, there are also potential limitations. For instance, a SMS-only approach makes it hard to replicate the "health calendars" in the original Thinking Healthy program.

Not wanting to lose this component, we decided to create a printed companion workbook for participants. During the design process, we decided to expand the scope of the book to include space for journaling. Some studies suggest that expressive writing combined with other intervention models may lead to better health outcomes, but the evidence is mixed.

We recognize that the reading and writing approach will not be a good fit with everyone, but we see this journal as a first attempt to create curriculum materials designed specifically for pregnant women and new moms. Ideally the next iteration moves this content from printed booklets to rich media like videos, illustrations, and narration delivered via platforms like WhatsApp, Facebook Messenger, or a standalone smartphone app.

We are sharing this journal under a Creative Commons license (CC BY-NC 4.0). This means you are free to copy and redistribute the material in any medium or format, as long as: (a) you give appropriate credit, provide a link to the license, and indicate any changes made; (b) if you remix, transform, or build upon the material, you share your work with the same CC BY-NC 4.0 license; and (c) you do not use any of the material for commercial purposes. See the license for full details and disclaimer of warranties and limitation of liability. This journal has not been endorsed by any individuals or groups, including the World Health Organization. Editable Google Doc files are available upon request.