Adapting an Anxiety Sensitivity Intervention for Perinatal Mental Health: Development of a Digital Intervention

Introduction: The goal of this study was to adapt an anxiety sensitivity intervention for mobile health delivery to perinatal populations experiencing economic marginalization. Methods: A community-engaged and user-centered design approach informed the prototype of Reaching Calm. We conducted "think-aloud" interviews with perinatal individuals (n=15) experiencing elevated anxiety and economic stressors. Acceptability and usability were assessed with the Treatment Evaluation Inventory Short Form (TEI-SF) and System Usability Scale (SUS), respectively. We used rapid qualitative analysis to analyze interviews and the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to characterize adaptations. Results: Mean TEI-SF and SUS scores were 4.3 and 88.0, respectively. Participants reported the content was helpful, values consistent, addressed cultural norms, and elicited feelings of reassurance. Recommendations included additions to content and options for customization. Adaptations included modifications to context and content. Conclusions: Findings suggest high acceptability and usability. Community-engaged, user-centered design may enhance digital intervention acceptability for perinatal individuals.