Barriers to the use of digital mental health applications for depression among pregnant adolescents in DIMAMO, Limpopo province.
1
Nursing Science, University of Limpopo, Polokwane, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2288
ABSTRACT
BACKGROUND:
Digital mental health applications (DMHAs) have the potential to reduce depressive symptoms among pregnant adolescents. However, their uptake remains limited in rural public health settings such as DIMAMO. Guided by an integrated Health Promotion Model (HPM) and Unified Theory of Acceptance and Use of Technology (UTAUT) framework, this study explored perceived barriers influencing the use of DMHAs among pregnant adolescents and professional nurses.
METHODS:
A descriptive qualitative design was employed to explore perceived barriers to DMHA use among pregnant adolescents and professional nurses in public healthcare facilities. Data was collected through in-depth, semi-structured interviews with purposively selected participants. Data were analysed using thematic analysis, with emergent themes mapped onto constructs of the HPM (perceived benefits, perceived barriers, interpersonal influences) and the UTAUT (performance expectancy, effort expectancy, social influence, and facilitating conditions).
RESULTS:
Barriers aligned strongly with both theoretical models. Challenges related to data costs, poor network coverage, and unstable connectivity emerged under facilitating conditions (UTAUT) and perceived barriers to action (HPM), limiting consistent DMHA use. Effort expectancy concerns were reflected in difficulties navigating applications and sustaining engagement, while doubts about effectiveness corresponded with performance expectancy and perceived benefits of action. Pregnant adolescents expressed a preference for in-person support, highlighting the importance of interpersonal influences (HPM) and social influence (UTAUT). Concerns regarding sustained interest and compliance further affected behavioural intentions. From a health system perspective, professional nurses reported workload constraints, limiting their capacity to promote and support DMHA use.
CONCLUSIONS:
An integrated HPM-UTAUT framework provides a comprehensive understanding of individual, technological, and system-level barriers to DMHA use. Addressing connectivity challenges, strengthening perceived benefits, supporting interpersonal engagement, and reducing nurses’ workload may enhance adoption of digital mental health interventions for pregnant adolescents in public health settings.
Digital mental health applications (DMHAs) have the potential to reduce depressive symptoms among pregnant adolescents. However, their uptake remains limited in rural public health settings such as DIMAMO. Guided by an integrated Health Promotion Model (HPM) and Unified Theory of Acceptance and Use of Technology (UTAUT) framework, this study explored perceived barriers influencing the use of DMHAs among pregnant adolescents and professional nurses.
METHODS:
A descriptive qualitative design was employed to explore perceived barriers to DMHA use among pregnant adolescents and professional nurses in public healthcare facilities. Data was collected through in-depth, semi-structured interviews with purposively selected participants. Data were analysed using thematic analysis, with emergent themes mapped onto constructs of the HPM (perceived benefits, perceived barriers, interpersonal influences) and the UTAUT (performance expectancy, effort expectancy, social influence, and facilitating conditions).
RESULTS:
Barriers aligned strongly with both theoretical models. Challenges related to data costs, poor network coverage, and unstable connectivity emerged under facilitating conditions (UTAUT) and perceived barriers to action (HPM), limiting consistent DMHA use. Effort expectancy concerns were reflected in difficulties navigating applications and sustaining engagement, while doubts about effectiveness corresponded with performance expectancy and perceived benefits of action. Pregnant adolescents expressed a preference for in-person support, highlighting the importance of interpersonal influences (HPM) and social influence (UTAUT). Concerns regarding sustained interest and compliance further affected behavioural intentions. From a health system perspective, professional nurses reported workload constraints, limiting their capacity to promote and support DMHA use.
CONCLUSIONS:
An integrated HPM-UTAUT framework provides a comprehensive understanding of individual, technological, and system-level barriers to DMHA use. Addressing connectivity challenges, strengthening perceived benefits, supporting interpersonal engagement, and reducing nurses’ workload may enhance adoption of digital mental health interventions for pregnant adolescents in public health settings.
| eISSN: | 2654-1459 |
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