Securing the evidence and theory-based design of an online intervention designed to support midwives in work-related psychological distress

The psychological wellbeing of midwives can be linked to the safety and quality of maternity care. As such, work-related psychological distress in midwifery populations must be addressed in order to meet the United Nation’s Sustainable Development Goals for maternal health. Earlier research maps out a global vision, using telemedicine and e/mHealth for the design and development of an online intervention designed to support midwives in work-related psychological distress. This paper outlines how the evidence and theory-based design of such an intervention has been secured via a narrative review, a critical realist review, a 2-round Delphi study and a mixed-methods systematic review of the literature. Findings suggest that this online intervention should be designed to provide anonymity and confidentiality for midwives seeking support online. 24-hour mobile access, effective moderation, an online discussion forum, and additional legal, educational, and therapeutic components are also indicated for collation in a ‘One stop shop’ online. Additionally, a simple user assessment may be used to identify those people deemed to be at risk of causing harm. The comprehensive design for this particular intervention is outlined using a validated checklist and guide. This particular design has been informed by the pathways disclosure model and the revised transactional model of occupational stress and coping. This research has been guided by the Medical Research Council’s framework for developing complex interventions. Future research in this field is also suggested. Should this intervention be developed and tested more widely, both midwives and maternity service users may experience safer, more productive and higher-quality maternity care.