(PS1-59) Preliminary Acceptability, Feasibility, and Lessons Learned using Ecological Momentary Assessment (EMA) to Assess Anxiety during the Perinatal Period

Elevated anxiety symptoms are prevalent in the perinatal period, affecting up to 17% of birthing parents. Anxiety disorders during the perinatal period are often overlooked in clinical practice and have negative sequelae for maternal and child health, demonstrating a critical need to increase identification and treatment. Ecological Momentary Assessment (EMA) has been proven to be a feasible and acceptable way to examine temporal relationships between anxiety, sleep, and activity and has been employed in the screening, assessment, and intervention of anxiety disorders. However, much is unknown about the complex daily relationships between anxiety, sleep, and activity in the perinatal period. Therefore, we designed a longitudinal (28-day) pilot study of EMA via wearable technology to better understand how anxiety develops and is maintained during the perinatal period. The pilot study consists of baseline self-report questionnaires, a 4-week EMA assessment period, qualitative exit interview, and post-study self-report questionnaires. During the assessment period, participants complete a variety of daily EMA questionnaires related to anxiety/mood, sleep, social support, suicidal urges, and infant concerns. Additionally, Fitbit devices are worn to collect passive data on physical activity and sleep. Acceptability and feasibility are evaluated based on compliance to EMA questionnaires and participant retention. Baseline and post-study self-report anxiety measures are reported to examine whether daily assessment impacts anxiety symptoms. Rapid qualitative analysis is used to identify themes related to acceptability, usability, and suggestions for improvement from the focused exit interview. 17 pregnant and 17 postpartum individuals participated in the pilot study. With regards to the feasibility of using EMA technology in the perinatal period, this study to date, has maintained a 100% retention rate (N=30), indicating strong feasibility. GAD-7 scores from baseline (M=14.60, SD=2.71, N=30) to follow-up (M=10.70, SD=3.81, N=30) indicate a reduction in anxiety symptoms between both pregnant and postpartum participants, t(29) = 5.58, p < .0001. Rapid analysis of qualitative interviews indicated themes related to an appreciation of using EMA as a mental check-in, increased association between sleep and anxiety levels, increased insight into daily anxiety triggers, and effortful behavioral changes due to knowledge gained from EMA assessment. These initial findings, along with the decrease in anxiety severity at follow-up, suggest that increased internal awareness of anxiety may improve coping with everyday anxiety. Further lessons learned from the rapid analysis of the qualitative exit interviews will be reported to elucidate the acceptability, feasibility, and usefulness of EMA to people with anxiety during the perinatal period. This data may guide future research studies on EMA with a perinatal population to better understand anxiety triggers and the optimal time for intervention during the perinatal period.