eHealth app for Northern maternal health care being developed

Lakehead University researchers — from left, Dr. Pauline Sameshima, Dr. Jennifer Chisholm, Abigale Kent, Dr. Helle Moeller and Dr. Manal Alzghou — have been working on a research project focusing on maternal health care for Indigenous and immigrant women in Northwestern Ontario.

A program for mobile devices may provide access to the health care and education that mothers-to-be in Northwestern Ontario feel they often don’t receive. Supported by the Thunder Bay District Health Unit, an eHealth app is being adapted by researchers at Lakehead University to fit the needs of women in this region, particularly Indigenous and immigrant women. This will hopefully help close this gap in maternal care and education.

“We know from interviewing women in this area that there is a need for mental health care and services in our region,” says Dr. Helle Moeller, an associate professor in Lakehead’s department of Health Sciences. “We also know few women, compared to the rest of Ontario and nationally, access pre-natal education. So we would like to offer an alternative tool for mental health education care, and support for women in their pregnancy and post-partum period.”

Moeller, who is also associate director of the Centre for Rural and Northern Health Research, has a long-standing interest in equity in access to health and health care as well as Northern, Indigenous and women’s health.

A project started in 2013 looked at the birthing experience of women in Thunder Bay. Interviews with diverse women, including Indigenous women and women from refugee and immigrant backgrounds, reported being less well-treated in the health-care system, and provided with less information about the pre-natal education and care options available to them than the broader community. Many perceived birth to be inherently risky and Indigenous women felt the primary care providers reinforced this perception. They felt providers considered them “high risk,” and were often not informed about the option of midwifery care.

In 2017 the project was expanded to focus on pre-natal education. It involved interviews with another 40 women from varied backgrounds. The results revealed vast differences in access to pre-natal care and education.

“Women in Northern communities and women that come from diverse backgrounds do not have access to the same level of pre- and post-natal care and education as other women,” Moeller says. That is primarily due to: socioeconomic, linguistic and cultural differences, and the perception of racism and discrimination. Also, being on one or the other end of the age spectrum and not living close to where the programs are offered poses challenges.

“That issue of travel really prohibits women in northern communities from participating” in pre-natal programs, says Moeller.

Importantly, nearly half the participants indicated there was not enough mental health support services, in outlying communities as well as in Thunder Bay, Sioux Lookout and Kenora.

“Fifty per cent of women that we interviewed stressed that they had mental health needs they felt were not met during pregnancy and post-partum,” Moeller says.

A team in Alberta has successfully piloted a software application that provides educational mental health modules, online screening for depression and anxiety, and access to counselling and support during pregnancy and post-partum. The Thunder Bay team hopes to customize the app for women in this region to use.

“Social service and care providers see that the app has great potential,” Moeller states. “But there will need to be some adaptation in terms of language, culture, how the curriculum is put together.”

Abigale Kent, a master of Health Sciences student, has been the research co-ordinator on the project. In addition to supporting the efforts of the team generally, her thesis has focused on one leg of the project, interviewing providers servicing predominantly Euro-Canadian women and their perceptions on the suitability of an eHealth app for maternal mental health in the Northwest.

“I work with a fantastic and supportive team in building community connections, setting up interviews and putting together the building blocks that are going to ensure this app and the project succeeds,” Kent says.

When she graduates in August, Kent hopes to enroll in medical school having just been interviewed at NOSM.

Along with Moeller and Kent, the current team consists of: Dr. Manal Alzghoul, assistant professor in Nursing; Dr. Jennifer Chisholm, assistant professor in the department of Women’s Studies; and Dr. Pauline Sameshima, professor in Graduate Studies & Research in Education and Canada Research Chair in Arts Integrated Studies. The team has been funded by Women’s Xchange of Women’s College Hospital, Toronto, and the SSHRC Explore Research Development Fund.

Written by Julio Heleno Gomes

Story originally appeared in The Chronicle Journal on June 12, 2020