AUTHOR=Rizzi Silvia , Nicoletti Anna Elena , De Luca Chiara , Poggianella Stefania , Dalmonego Carlo , Paoli Caludia , Marroni Debora , Burlon Barbara , Chiodega Vanda , Dallafior Martina , Pertile Riccardo , Rizzi Silvia , Valentini Laura , Alberi Irene , Forti Stefano , Taddei Fabrizio 

TITLE=Prevention of postpartum depression via a digital acceptance and commitment therapy-based intervention: protocol for a pilot usability study

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1633229

DOI=10.3389/fpsyt.2025.1633229

ISSN=1664-0640

ABSTRACT=IntroductionThe perinatal period — encompassing pregnancy and the first months after childbirth — is a time of increased psychological vulnerability. It is often associated with high levels of anxiety, stress and depression. Access to psychological support is frequently limited by stigma, geographical barriers, and a shortage of services. Digital health interventions offer promising solutions to overcome these obstacles.MethodsThis study evaluates the acceptability, feasibility, and user experience of REA, a virtual coach based on Acceptance and Commitment Therapy (ACT), to promote psychological well−being and prevent postpartum depression (PPD). Fifty pregnant women (25–30 weeks of gestation) will be recruited. The 8−week intervention delivers psychoeducational content via text, audio, and video, and collects steps, sleep, and heart rate via smartwatches for triangulation with self−reported measures. User Experience (UX) and User Engagement (UE) will be assessed with the System Usability Scale (SUS), the User Engagement Scale–Short Form (UES−SF), the Italian Chatbot Usability Scale, version B (ITA BUS B), and the User Version of the Mobile Application Rating Scale (uMARS), alongside semi−structured interviews. Psychological outcomes will be assessed pre–post with the two Whooley Questions, the Center for Epidemiological Studies Depression Scale (CES−D), the Multidimensional Psychological Flexibility Inventory (MPFI), and the 12−Item Short Form Health Survey (SF−12).Expected resultsThe intervention is expected to demonstrate high levels of user satisfaction and engagement (SUS ≥ 68, UES-SF ≥ 3,5/5; ITA BUS B ≥ 44/55 (≈4,0/5); uMARS ≥ 4,0/5), resulting in improvements in psychological flexibility, perceived well-being, and overall quality of life, recognizing that preventive efficacy will be evaluated in subsequent studies with controlled designs and postpartum outcome measures.DiscussionREA represents a scalable and accessible tool to support perinatal mental health, offering an innovative approach to the early prevention of postpartum distress.Trial registrationThis study was approved by the ethics committee of the APSS (Provincial Health Services Authority) under number 12090 (May 15, 2025).