New VID-KIDS app takes help online for mums with postpartum depression

For new mums living with the debilitating fallout of postpartum depression, an online version of the VID-KIDS parent support program developed by UCalgary researchers is more than just a new app — it’s a portal to professional help direct from their living room in a time of desperate need.

The app was developed in response to COVID-19, which paused the successful in-person version of the VID-KIDS parent training program. Led by Dr. Nicole Letourneau, PhD, RN, Alberta Children’s Hospital Foundation Chair in Parent-Infant Mental Health, that program saw trained RNs meet one-on-one with struggling new mums over several in-home visits. The nurses would show mums images of babies’ facial expressions, explain what they might mean, and take and share videos of the mothers’ interactions with their own babies.

Because those so-called “serve and return” exchanges are both vital to a baby’s healthy development and diminished by postpartum depression, mums were given training on how to read and respond to their babies’ cues. For example, if baby looks you intently in the eye, they might be ready to engage, to play, and to learn.

With in-home visits cancelled by the pandemic, and new parents more stressed and isolated than ever, the decision was quickly made to take VID-KIDS virtual, aided by an interdisciplinary nursing and software engineering team. For help, Letourneau looked to her uniquely qualified colleague Dr. Linda Duffett-Leger, PhD. An associate professor in the Faculty of Nursing and certified user-experience designer, Duffett-Leger’s expertise is in leveraging technology to optimize health and educational outcomes.

A purpose-built VID-KIDS app

“The team had trialled some commercially available apps, like Zoom, but had a lot of issues around agility, navigation, making it user-friendly, easy to access, and of course privacy and security concerns,” says Duffett-Leger. So the process to develop a purpose-built VID-KIDS app began.

“I liaised between domain experts — the nurses deploying the intervention in the home and the mums — and the software engineers,” Duffett-Leger explains. “So often, nurses have to use a lot of technology, but they are left out of the development. The result is either the technology isn’t used, or it isn’t optimized. We didn’t want that.”

Honouring the expertise of the user, as Duffett-Leger puts it, resulted in weekly design sessions and focus groups of mums and nurses. “This was truly an interdisciplinary team effort. Our close collaboration with colleagues from software engineering was critical in making VID-KIDS Virtual a reality.”

Over time the app took shape into a fully integrated cloud-based system, offering nurse interventionists the ability to securely and easily schedule visits and send notifications, take and share videos, navigate through assessment tools, embed teaching materials, connect with researchers, and enable deep analytics.

Invaluable input from mothers

One of the mums who worked with Letourneau and Duffett-Leger was Tracy Walters. With two young daughters, Walters had been through the in-person VID-KIDs program, and was keen to help new mums benefit from the app.

“When you are going through postpartum depression, you feel like you are drowning, like you are under water and it’s just this internal battle,” she explains. “I wasn’t noticing that my baby kind of wanted me to play, to be interacting. I was just wondering am I doing anything right?”

The VID KIDS training helped her make sense of her baby’s expressions, improving the connection she felt with her baby. It also broke things down into bite-sized pieces she could manage. “It simplified everything, and broke it down, which is what you need when you are depressed. So I was like oh, okay, she’s looking at me, she’s engaged, I’ll bring in a toy. That’s doable.”

Being part of the app development process for Walters meant taking part in focus groups, offering suggestions for improvements and user-friendly design. “They were into everything that we were saying,” Walters says. “As a new mum you are isolated, and to have an app you can access, say, in the middle of the night when your baby happens to be up, with tools to help you, it will be really neat to see. It’s like a baby translator, it’s just the most amazing thing!”

Parents interested in the VID-KIDS program can visit the CHILD website for more information.

Peak Scholar recognition

For her work helping convert the VID-KIDS program to an app — and her contributions to a couple of other projects that went virtual with the advent of the pandemic — Duffett-Leger has been named a Peak Scholar, recognition awarded this year specifically for COVID-19 innovation excellence, addressing the global need created by the pandemic.

“I don’t know where I would have gone if I didn’t already know Linda,” says Letourneau. “I honestly don’t know any other nurse scientists doing discipline-spanning work in user-engaged design, with the kind of partnerships and connections that Linda has. We are really lucky to have her here, and the pandemic certainly highlighted the value of that skill set.”

“There is a silver lining to this pandemic,” Duffett-Leger says. “It’s terrible, but at the same time, it has opened up the opportunity for us now to scale this out to actually access more mums, particularly in those rural remote areas where they might not have had access to these in-home supports.”