Documentation 2 - Research Summary
Project Overview
Purpose
Postpartum Depression is a serious issue. New moms are having stress both physically and mentally. However, Postpartum Depression is preventable and treatable. Therefore, situations would become better when society has awareness of the issue. I am going to create a game to advocate family support for Postpartum Depression. With the primary targeting audience of new dads, it would provide the family a . By playing the game, new dads could be confident to navigate through the “blue period” with new moms.
Objective
Arouse the awareness of the importance of family support for Postpartum Depression.
Educate families about Postpartum Depression, and help them feel comfortable when dealing with the problems.
Better preparation mentally and emotionally.
Research
Research Literature
According to the research, “Between 50% and 80% of new mothers experience an episode of the “baby blues,”” [1] “The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13%.” [2] Some consider Postpartum Depression as a mood issue that new moms are not happy, and they are tired. However, “Postpartum Depression is defined as the most recent episode of major depressive disorder (MDD) or of bipolar I or bipolar II disorder, if the episode has an onset within four weeks postpartum.” [1] New moms are having a time of heightened vulnerability to depressive mood changes in the months followed by delivery, and it can be twice as high as during other periods in a woman’s life.
The factors of having a hard time are because of the abrupt and dramatic changes occurring in hormone levels and other life-based causes such as marital relationship, low social support,stressful life events and so on. In China specifically,
Of the 1126 participants, 524 (46.5%) lived only with their husbands, 387 (34.4%) lived with their parents-in-law, and 215 (19.1%) lived with their parents. Compared with those living only with their husbands, puerperal women living with their parents-in-law had higher risk of postpartum depression after adjustment for potential confounders. [3]
In addition, “living with parents-in-law may be a risk factor for postpartum depression among Chinese puerperal women. Future preventive interventions should include strategies that target the puerperal women who lived with parents-in-law.” [3]
The treatment for the Postpartum Depression are mainly two ways, controlled trials of psychological interventions and medication.
Controlled trials of psychological interventions have validated a variety of individual and group interventions. Medication often leads to depression improvement, but in controlled trials there are often no significant differences in outcomes between patients in the medication condition and those in placebo or active control conditions. [4]
Since some mothers are still breastfeeding, medication may not be their first choice and controlled trials are preferred.
“The prevention of Postpartum Depression is feasible and effective. It is necessary to integrate mental health screening into routine primary care for pregnant and postpartum women and to follow up this screening with treatment or referral and with follow-up care.” [4] Although it is hard to do in China, where the ratio of Doctor to Patient is small, it is doable for the public to cooperate with professionals and hospitals.
Works Cited
[1] Vliegen, Nicole PhD*; Casalin, Sara PhD*; Luyten, Patrick PhD The Course of Postpartum Depression, Harvard Review of Psychiatry: January/February 2014 - Volume 22 - Issue 1 - p 1-22doi: 10.1097/HRP.0000000000000013
[2] Victoria Hendrick, Lori L. Altshuler, Rita Suri, Hormonal Changes in the Postpartum and Implications for Postpartum Depression, Psychosomatics, Volume 39, Issue 2, 1998, Pages 93-101, ISSN 0033-3182, https://doi.org/10.1016/S0033-3182(98)71355-6.
[3] Yue-Yun Wang, Hui Li, You-Jie Wang, Hong Wang, Yan- Ru Zhang, Lin Gong, Jian Ma, Yan Wang, Ming-Zhen Wang, Shi-Xian Qiu, Shi-Xin Yuan, Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China, Journal of Affective Disorders, Volume 218, 2017, Pages 335-338, ISSN 0165-0327, https://doi.org/10.1016/j.jad.2017.04.052. (https://www.sciencedirect.com/science/article/pii/S0165032716314756)
[4] Postpartum Depression: Current Status and Future Directions, Michael W. O'Hara and Jennifer E. McCabe, Annual Review of Clinical Psychology 2013 9:1, 379-407
Project Background
Problem and Goal
Problems
It is hard to find reliable sources online without consulting professionals. However, making appointments with professional costs. It takes months to wait and hundreds of dollars to seek professional help. New parents may not be able to spend that much time and money on it.
It is significant to have a priming in mind to prevent from having postpartum depression.
Reading papers and articles online is boring, and watching videos takes time.
Goals
To provide a rehearsal experience for expecting parents to understand the scientific information about postpartum depression, including why it happens, what the symptoms are and how to deal with it.
To provide a reliable source for expecting and new parents so that they would spend less time and keep the right solution in mind.
To provide a playful, interactive and immersive experience to make education effective.
To advocate family support for postpartum depression and give new parents an optimistic mindset.
Design Precedents
Depression Quest
“Depression Quest is an interactive fiction game, which presents descriptions of various situations and prompts the player to choose their response. In addition, most pages feature a set of still images and atmospheric music. The game has over 40,000 words of text, and multiple possible endings.”
Depression Quest did a very good job in terms of making the experience of feeling like a patient of depression.
Coming Out Simulator
“Players would experience as a semi-fictional version of designer, on a night that changed his life forever. By choosing their words wisely. Players would figure out how to approach their hyper-conservative Asian parents. And if all that seems confusing or awkward... well, that's the gist of coming out as queer, isn't it?”
Coming Out Simulator inspired me to tell the story in a very unique way. It also gave me the idea of doing a messaging game. Their way of interacting with players is fantastic.
Bury Me My Love
“Bury me, my Love'' tells Nour’s story as she flees Syria and tries to reach Europe. But why did the young woman decide to leave? Bury me, my Love is a reality-inspired interactive fiction designed for mobile phones. Communications will occur in pseudo real-time. How will Players best help?”
Bury Me My Love is another game that inspires me of the game mechanics. I also really like how it tells the story.
Stakeholders Interviews and Observations
Participants:
2 New Moms
3 New Dads
2 Professionals
Questions:
Interview Question of Capstone for Parents: Link
Interview Question of Capstone: Link
Observation:
H. is a dad of two. He is self-employed and currently works from home. He feels like with the experience from Baby 1, taking care of baby 2 is much easier. Having a second child does not make them feel overwhelmed. His wife feels more joy compared with her feeling with baby 1. Also the previous experience with baby 1 makes baby 2 much easier. [Having a second child is easier both physically and mentally since they know what is going to happen and the solutions. ] They are so excited with the arrival of the second baby, and how the baby tries to send his message to them surprises them most. However, Keeping life work balance stresses them most. Lack of sleep stresses them most. He focuses on the family for now to solve the issue. He felt he needed to start doing some investment to increase their household income. The way he uses to conquer his stress is to find out what specific things triggered the stress. Then finding the solution for the thing is the best way for us to relieve stress. To his knowledge, Postpartum Depression is a emotion issue can cause serious problem including commit suicide. The fears of changes, the uncertainties of future, the changes of the hormone and injury during the labor are the most common reasons triggered Postpartum Depression. He got the information from the college general psychology class, and he did a project related to Postpartum Depression. From his perspective, the best solution is to seek professional help. He thinks spouse is the most important person in parenthood, and the way they use to find out the solution is to communicate with each other and learn from each other. The support from the spouse and the baby respond are the best thing to relieve his stress. Google and Youtube are the most used resources, and he watches videos about how other people do to know what he should do. He would check with other people who have the same issue and make sure nobody is getting hurt physically and mentally. However, most of the information is useless, and it was the greatest obstacle. Communication with each other, supporting each other, taking turns to take care of the baby. Learn from other parents. Keep this in mind “ you are not the only one who has this issue! Go ask.” Focusing on what you got. Do not create a story to make things make sense for yourself.
X. is a dad of one. He is a master student who is going to graduate. Currently he is lacking sleep. Although it is better compared to the postpartum period, still. His daughter is demanding more attention which makes him feel confused. The balance of life and work is another issue that makes him feel bad. The experience after being a parent surprises him most. He feels like the preparation is never enough, and he never understands the feeling until he experiences it. He was confused and chaos, he sometimes had conflicts with other family members. But later on he understands that it is what it is, and accepting life is the best way to adjust the mental status. His wife used to travel and hike a lot, however she is trapped in the apartment and only has limited exercises since the current situation. She bares it and adjusts her emotion to better work. They used to have fights because of him as a dad not doing a good job from his wife’s opinion. His wife cannot relieve her stress in her favorite way, no hiking, no traveling, no fun, no food. She is making good progress on her job though, which makes her feel a sense of achievement. The most important people are the ones he trusts. One of the people who helped him most is the Lactator Consultor. She told him that you should never expect a baby from what they could not do, and it is what it is, he should accept it. For him, staying alone, cooking and cutting food is stress relieving. Their method to have a calmer mind is to lower the expectation. Focus more on the kid. And stop thinking about the problem, instead deal with it and if not bypass it. The sources he uses to find out the solution of parenting is google and some parenting apps. However, sometimes the information is different. Time is another issue, you cannot prepare for everything, and you can not search for the result you want immediately. When he faces some issues, he takes a breath and tries not to worry about it. Looking for the way it works and working on it.
Z. and Y(wife)’ s everyday starts from changing diapers and feeding my baby. The biggest change for Z. is to balance my work and baby’s things. He has to do his work after his baby falls asleep. He spent more time taking care of his baby at home instead of hanging out with friends. He has fewer and fewer of my individual activities. He feels very happy and grateful after having my baby. His wife is very positive most of the time. She is very grateful for every tiny change during that special time. He thought he and his wife are not able to take care of the newborn very well on their own, which stresses me a lot. But there are some friends of his, they are his role models who did it very well even without any help from their parents. He gained more confidence and encouragement which made him feel relieved. When his wife feels sad or negative, he gives some emotional support, for example, encouraging her and complimenting her. His wife would not struggle in the negative mood. He was very stressed when he first knew he was going to have a baby, due to no parent help. Nobody can help him or share some information with them. He cannot even sleep very well with so much pressure. Fortunately, he has nice friends here who have baby so they share useful information with them. The biggest challenge for him is to balance his work and life. He has a lot of communications with his wife to let her know his schedule so that she could know when and how long he should be focused on his work everyday. It is a team work for them. He would hang out with his friends or be close to nature to relax. Beautiful view makes them feel relaxed. His wife is not having any emotional problems. If she had, he will be a good listener and give her some positive emotional support. He knows Postpartum Depression because his wife told him there are some postpartum depression tests for new moms. From his perspective, baby blues are because of the big changes of the Hormones. He knew it before his wife delivered the baby, that’s the first time he heard of it. She got this information from the clinic and shared it with him. He agrees that mental health is very important for new parents. And searching for professional help from doctors is the best solution for him. He does not agree that knowing more information about the Postpartum Depression would prime in mind and cause the higher possibility to get the postpartum depression. Conversely, he thinks more information about postpartum depression may help them do some preparation before it becomes a big mental problem. Spouse is the most important person. He will ask friends and doctors, read related professional books and search for information on the web to solve the problems. Some professional books about expecting a baby help him most, and his friends recommend it to him. He also searched on the web. He read related parts of the book at different stages of his parenthood to do preparations. The most important thing to consider when he is dealing with issues in parenthood is to communicate and cooperate more and effectively with his wife. The greatest obstacle he has is that most of his friends are young and have not got married and they could not be shared with information. Encouragement from his wife that they know they are both new parents so they try not to complain to each other, conversely they give more compliments to encourage each other. He would like to do more preparations before a mental problem comes. Read some professional books about expecting a new baby, and care more about mental health during parenthood and postpartum period. Good communication and cooperation with partners is the key to keeping a calming mind. He feels more relaxed since he has become skilled at taking care of the newborn.
L. is an anesthetist of the OB/GYN department. She is also a holder of a maternity class. She has done very decent research on labouring. According to her opinion, animals are calmer than human when it comes to the condition with less social, going out and sex. The reason humans are having a harder time in the postpartum period is because newborns require more companions and care, and new moms are feeling helpless and useless in this period. The reason for this is because of the conflict of their mind, what they have and what they want. They are having trouble switching from their life to a full time job of taking care of kids. Sometimes it can also happen even when they are taking care of the child but they find out that they are not connected well to the society, this includes the social and work. They become anxious because of this reason. Taking care of the baby needs them to learn new skills, and new moms nowaday are tend to search online or ask from professionals. However, the key to solve the problem usually is the instinct of new moms, and over relying on knowledge and doctors would lower the instinct. Taking care of the baby is hard and overwhelming, however it is the most happy thing in the world. If new moms could feel the happiness of raising a kid, they will become more positive and have a stable mind. They are having a new identity when their new baby arrives, and they are growing up with them. They need the skill of accepting the bad emotion. To consider the real meaning of life and adapt to new life. People are describing too horrible of the experience of raising a baby. To prevent: researsal. To deal: stable mental, to be grateful, instinct and skills, to develop the skill of making themselves happy, relieve the fear of uncertainty, less rely on knowledge and other people, understand each challenge is the method to become strong. The ability to balance, enjoy what you have, and want what you want, never give up hope, leave it to time and enjoy the current time.
Modeling
Audience(Demographic)
New/Expecting Dads
Gender
Male
Age
25-35
Occupation
New dads who just have a newborn baby. Not necessarily to be first time dads.
Income Level
No fixed income level, but more likely to be 50k-150k a year.
Family Environment
Living with their wife and baby.
May live with their parents-in-law or parents.
Stressful and exhausted because of the newborn. Overwhelming, and they may need to balance their life and work.
Education
High school and higher. More likely to be bachelor and higher.
Expecting/New Moms
Gender
Female
Age
20-35
Occupation
New moms. Any jobs. Can be full time moms.
Income Level
No fixed income level.
Family Environment
Living with their husband and baby.
May live with their parents-in-law or parents.
Stressful and exhausted because of the newborn. Overwhelming, and they need to recover from the postpartum period.
Stay at home, not able to do things they liked before. No way to relieve the stress.
Education
High school and higher. More likely to be bachelor and higher.
Personas
Scenarios
Design Questions (Design Opportunities)
How can I give them the information without priming in mind?
How can I make the story interesting without being overwhelming and offensive?
How can I narrate a strong story by using messaging mechanics?
How can I educate players efficiently and interestingly?
How can I write a story players resonate to?
Concept
Key Insight
It is hard to find reliable solutions within a short period of time. However, the postpartum period is an overwhelming time, and new parents lack time and energy.
New parents prefer solving issues by looking up information and articles online by themselves instead of seeking professional help due to little time and other reasons.
Information online is not reliable enough for them to solve the issue. Wrong way may cause serious problems.
Reading articles and watching videos online is not interesting enough. It may not be relaxing for new parents to relieve their stress during their own time.
Mental issues are overwhelming. Self learning in terms of mental problems is hard. They may be worried.
Young parents prefer information that is fun and interactive and immersive. They are more likely to remember what they learned when they had fun.
Concept Statement
Giving birth to a baby is a special moment of every parent’s life. This special moment brought both the greatest happiness and extreme difficulties. When a baby is born, the dramatic Hormone change and extreme lack of rest will drag a woman into an almost inevitable “baby blues”. This “baby blue” can develop into a real issue, Postpartum Depression. According to research, 50%-80% of the new moms have “baby blues'' in the Postpartum period. 13% of new moms get Postpartum Depression. Suffering from mental health problems has a negative impact on both new moms and babies. Not to mention that new dads can also get Postpartum Depression. However, this issue is totally preventable during the prepartum, and postpartum period as long as new moms and their family members are having a correct vision of Postpartum Depression. Introducing Be Her Ally, a social impact game that would educate new parents about Postpartum Depression and advocating for family support in a more interactive and immersive experience. Players will play as a new dad to explore what happens to “their wife in problem” by messaging and talking to their “family members” and “friends”. They will know the scientific information about the Postpartum Depression and find out the right way advised by professionals to deal with it. This game would either be developed by Twine or Unity. It could be a self-educating game, and a tool for professionals and maternity class holders to use to help with their patients.
Design Solutions - Key functionality and features/Design Framework
Two story lines
Mini games
Prototype
