Appendix 1. Example Questions from the Baseline Qualitative Interview

Appendix 1. Example Questions from the Baseline Qualitative Interview

Question Goal / Example Questions
Participants who had already sought care
Factors leading participants to seek care / “What motivated you to go?”
“Were there other factors or people that encouraged you to go?”
“Is there anything that would make it easier for you to go to future appointments?”
Specific questions about obstetrician/midwife recommendations / “Has your obstetrician or midwife suggested that you get help for high levels of stress or anxiety?”
IF YES: “What was your reaction to that?”
Factors that made making subsequent visits a challenge / “What do you think might get in the way of you going for another visit?”
“What types of barriers did you face when trying to make an appointment?”
“When you call is it hard to get an appointment with a counselor?”
“What about transportation? Fitting it into your schedule? Something else?”
“Did you feel too embarrassed to make an appointment? Why?”
Participants who had not already sought care
Assessing plans to receive mental health care and possible barriers / “Do you plan to see a counselor or therapies about the stress?”
IF YES:

• “Why?”
• “What might get in the way of getting treatment?”
• “Do you know where to call to get an appointment?”
• “Is transportation a challenge?”
• “Fitting it into your schedule?”

IF NO:

• “Why Not?”
• “Are there other reasons, like no knowing who to go see?”
• “What about transportation, is that a problem?”
• “Are you concerned about taking medication during pregnancy?”
• “Did you feel embarrassed or overwhelmed when trying to make an appointment? Why?

“Do you feel like seeing a counselor or therapist would be helpful?”
Factors increasing likelihood of seeking treatment / “What would make it more likely that you would seek treatment?”
IF INTERVENTION: “What about the gift card from this project. Do you think that will motivate you to make an appointment with a counselor or therapist?”
Assessing coping mechanisms participants have or can develop / “Are there things, other than counseling that you do for yourself that help you reduce your stress during your pregnancy?”
“Are there things that you aren’t doing now, but if you were able to do them you would to help you deal with the stress?”

Appendix 2. Example Questions from the Follow-up Qualitative Interview

Question Goal / Example Questions
Participants who did receive mental health care during pregnancy
Assessing amount of care received / “How many mental health visits did you have while you were pregnant?"
Factors leading participants to obtain care / “What were the factors that got you to see a mental health professional during your pregnancy?”
“Were there other factors?”
“How much did talking to Natalie, the prenatal care coordinator at LIPA, get you to go see a mental health professional?”
“Did your obstetrician recommend you go?”
“Was there something else that got you to go see a mental health professional – like a recommendation from a friend? What that a motivating factor?”
IF INCENTIVE GROUP: Assessing impact of incentive / “The first time we spoke on the telephone, I explained that you would get a $10 gift card each time you went for a mental health visit. Did that help you to go see a mental health professional? Why or why not?”
“Did it motivate you to go for more visits?”
IF CONTROL GROUP: Assessing perceived impact of a financial incentive / “If you had been offered a $10 gift card to a supermarket each time you went for mental health care, do you think that would have gotten you to go see a mental health professional more often? Why or why not?”
Participants who did not receive mental health care during pregnancy
Factors that prevented them from obtaining care / “Can you tell me about some of the reasons you didn’t see a mental health professional”
“Were there other reasons you didn’t see a mental health professional?”
Factors that may have encouraged them to obtain care? / “Did your obstetrician or midwife ever recommend you get treatment for stress, anxiety or depression during your pregnancy?”
IF YES: “Did that make you consider going to see a mental health professional? Why or why not?”
IF INCENTIVE GROUP: Assessing impact of incentive / “The first time we spoke on the telephone, I explained that you would receive a $10 gift card each time you went for a mental health visit. Did that make you consider going to see a mental health professional? Why or why not?”
“Do you think the gift card would have gotten you to see a mental health professional if it was for more money?”
IF YES: “How much do you think it would have taken to get you to go?”
“What if the gift card was for another store? Could that have gotten you to go?”
IF CONTROL GROUP: Assessing perceived impact of a financial incentive / “If you had been offered a $10 gift card to a supermarket each time you went for mental health care, do you think that would have gotten you to go see a mental health professional? Why or why not?”