Analysis of Online Peripartum Depression Communities: Application of Multilabel Text Classification Techniques to Inform Digitally-Mediated Prevention and Management.

Peripartum depression (PPD) is a significant public health problem, yet many women who experience PPD do not receive adequate treatment. In many cases, this is due to social stigmas surrounding PPD that prevent women from disclosing their symptoms to their providers. Examples of these are fear of being labeled a "bad mother," or having misinformed expectations regarding motherhood. Online forums dedicated to PPD can provide a practical setting where women can better manage their mental health in the peripartum period. Data from such forums can be systematically analyzed to understand the technology and information needs of women experiencing PPD. However, deeper insights are needed on how best to translate information derived from online forum data into digital health features. In this study, we aim to adapt a digital health development framework, , toward translation of our results from social media analysis to inform digital features of a mobile intervention that promotes PPD prevention and self-management. The first step in our adaption was to conduct a user need analysis through semi-automated analysis of peer interactions in two highly popular PPD online forums: What to Expect and BabyCenter. This included the development of a machine learning pipeline that allowed us to automatically classify user post content according to major communication themes that manifested in the forums. This was followed by mapping the results of our user needs analysis to existing behavior change and engagement optimization models. Our analysis has revealed major themes being discussed by users of these online forums- family and friends, medications, symptom disclosure, breastfeeding, and social support in the peripartum period. Our results indicate that Random Forest was the best performing model in automatic text classification of user posts, when compared to Support Vector Machine, and Logistic Regression models. Computerized text analysis revealed that posts had an average length of 94 words, and had a balance between positive and negative emotions. Our Digilego-powered theory mapping also indicated that digital platforms dedicated to PPD prevention and management should contain features ranging from educational content on practical aspects of the peripartum period to inclusion of collaborative care processes that support shared decision making, as well as forum moderation strategies to address issues with cyberbullying.