Women's experiences of factors affecting treatment engagement and adherence in internet delivered Behavioural Activation for Postnatal Depression

article i nfo Introduction: Women with postnatal depression (PND) face significant barriers to treatment that may be over- come by internet based delivery of treatment. Demand for a self-help internet postnatal treatment offered via a parenting site was high, but attrition rates were also high. Aims:TogainpatientperspectivesonengagementandbarrierstotheNetmums' "HelpingwithDepression"treat- ment. Method: Semi-structured interviews were conducted with 17 participants selected from the Netmums trial. Results:Thematicanalysisrevealedmotivatorsandbarrierstotreatment.Womenreportedthatthe flexibilityand anonymity of internet interventions fit with their postnatal circumstances. They identified that the relevance of the intervention to their personal circumstances, expectations of motherhood, stigma about depression and motherhood, hopelessness about their ability to improve, previous negative experiences with treatment and treatment seeking, and a lack of practical and emotional support contributed to feelings of being overwhelmed. Womenwhofeltmore overwhelmedwere morelikelytodiscontinue treatment. Womensuggestedthatsupport would reduce the impact of barriers and improve adherence. Discussion:Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence.