Dataset Information

Adaptation of an evidence-based postpartum depression intervention: feasibility and acceptability of mothers and babies 1-on-1.

ABSTRACT:

Background

Mothers and Babies (MB) is a cognitive-behavioral intervention with demonstrated efficacy in reducing depressive symptoms and preventing depressive episodes among perinatal women when delivered in a group format by mental health professionals. Study aims were to describe the adaptation of MB into a 1-on-1 modality (MB 1-on-1) and provide data on the adapted intervention's acceptability and feasibility.

Methods

Seventy-five home visitors trained on MB 1-on-1 delivered the 15-session intervention to 1-2 clients. Client acceptability data assessed intervention enjoyment, comprehension, and usefulness. Home visitor feasibility and acceptability data measured amount of intervention material delivered, client comprehension, and client engagement.

Results

Home visitors were all female with 8.8 years of experience on average. 117 clients completed acceptability surveys. Average client age was 21.9 years and 41% were pregnant. Home visitors completely covered 87.9% of sessions and reported clients totally understood MB material 82.5% of the time across sessions, although variability was found in comprehension across modules. 82.0% of clients found MB 1-on-1 enjoyable and 91.6% said they totally understood sessions, when averaged across sessions. Clients enjoyed content on noticing one's mood and pleasant activities. Implementation challenges were client engagement, facilitating completion of personal projects, and difficulty shifting between didactic and interactive activities.

Conclusions

Clients found MB 1-on-1 to be enjoyable, easily understood, and useful. Home visitors reported excellent implementation fidelity and felt clients understood MB material. A refined 12-session version of MB 1-on-1 should be examined for its effectiveness in reducing depressive symptoms, given encouraging feasibility and acceptability data.

SUBMITTER: Darius Tandon S

PROVIDER: S-EPMC5896030 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Publications

Adaptation of an evidence-based postpartum depression intervention: feasibility and acceptability of mothers and babies 1-on-1.

Darius Tandon S S Leis Julie A JA Ward Erin A EA Snyder Hannah H Mendelson Tamar T Perry Deborah F DF Carter Mya M Hamil Jaime J Le Huynh-Nhu HN

BMC pregnancy and childbirth 20180411 1

<h4>Background</h4>Mothers and Babies (MB) is a cognitive-behavioral intervention with demonstrated efficacy in reducing depressive symptoms and preventing depressive episodes among perinatal women when delivered in a group format by mental health professionals. Study aims were to describe the adaptation of MB into a 1-on-1 modality (MB 1-on-1) and provide data on the adapted intervention's acceptability and feasibility.<h4>Methods</h4>Seventy-five home visitors trained on MB 1-on-1 delivered th ...[more]

PMID: 29642868

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Project description:BACKGROUND:Postpartum depression (PPD) has a 20% 3-month prevalence rate. The consequences of PPD are significant for the mother, infant, and the family. There is a need for preventive interventions for PPD, which are effective and accessible; however, many barriers exist for women who attempt to access perinatal depression prevention programs. Internet interventions for the treatment and prevention of depression are widely accepted as efficacious and may overcome some of the issues pertaining to access to treatment barriers perinatal women face. However, internet interventions offered without any human support tend to have low adherence but positive outcomes for those who do complete treatment. Internet support groups often have high levels of adherence but minimal data supporting efficacy as a treatment for depression. Taken together, these findings suggest that combining the treatment components of individual interventions with the support provided by an internet support group might create an intervention with the scalability and cost-effectiveness of an individual intervention and the better outcomes typically found in supported interventions. OBJECTIVES:This study aimed to describe the development of a cognitive behavioral therapy (CBT) internet intervention with peer support to prevent PPD and examine preliminary depression and site usage outcomes. METHODS:User-centered design groups were used to develop the internet intervention. Once the intervention was developed, women who were 20 to 28 weeks pregnant with symptoms of depression (Patient Health Questionnaire-8 scores of 5-14) but who had no major depression diagnosis were enrolled in a randomized controlled trial (RCT) to compare 8 weeks of a CBT-based internet intervention with peer support to an individual internet intervention designed to prevent PPD. Assessments took place at baseline, 4 weeks, 8 weeks (end of treatment), and then 4 weeks and 6 weeks postpartum. RESULTS:A total of 25 women were randomized. Of these, 24 women completed the RCT. Patient Health Questionnaire-9 scores at 6 weeks postpartum remained below the clinical threshold for referral for treatment in both groups, with depression measures showing a decrease in symptoms from baseline to postpartum. At 6 weeks postpartum, only 4% (1/24) met the criteria for PPD. There was no difference between groups in adherence to the intervention, with an average of 14.55 log-ins over the course of treatment. CONCLUSIONS:Results suggest women were responsive to both peer support and individual internet interventions to prevent PPD and that peer support may be a useful feature to keep participants adherent. TRIAL REGISTRATION:ClinicalTrials.gov NCT02121015; https://clinicaltrials.gov/ct2/show/NCT02121015 (archived by WebCite at http://www.webcitation.org/765a7qBKy).

Project description:Background: Currently, the eHealth field calls for detailed descriptions of theory-based interventions in order to support improved design of such interventions. This article aims to provide a systematic description of the design rationale behind an interactive web-based tailored intervention promoting HPV-vaccination acceptability. Methods: The 6-step Intervention Mapping (IM) protocol was used to describe the design rationale. After the needs assessment in Step 1, intervention objectives were formulated in Step 2. In Step 3, we translated theoretical methods into practical applications, which were integrated into a coherent intervention in Step 4. In Step 5, we anticipated future implementation and adoption, and finally, an evaluation plan was generated in Step 6. Results: Walking through the various steps of IM resulted in a detailed description of the intervention. The needs assessment indicated HPV-vaccination uptake remaining lower than expected. Mothers play the most important role in decision-making about their daughter's immunization. However, they generally feel ambivalent after they made their decisions, and their decisions are based on rather unstable grounds. Therefore, intervention objectives were to improve HPV-vaccination uptake and informed decision-making, and to decrease decisional conflict among mothers of invited girls. Computer-tailoring was chosen as the main method; virtual assistants were chosen as a practical application to deliver interactive tailored feedback. To maximize compatibility with the needs of the target group, a user-centered design strategy by means of focus groups and online experiments was applied. In these, prototypes were tested and sequentially refined. Finally, efficacy, effectiveness, and acceptability of the intervention were tested in a randomized controlled trial. Results showed a significant positive effect of the intervention on informed decision-making, decisional conflict, and nearly all determinants of HPV-vaccination uptake (P < 0.001). Mothers evaluated the intervention as highly positive. Discussion: Using IM led to an innovative effective intervention for promoting HPV-vaccination acceptability. The intervention maps will aid in interpreting the results of our evaluation studies. Moreover, it will ease the comparison of design rationales across interventions, and may provide leads for the development of other eHealth interventions. This paper adds to the plea for systematic reporting of design rationales constituting the process of developing interventions.

Dataset Information

Adaptation of an evidence-based postpartum depression intervention: feasibility and acceptability of mothers and babies 1-on-1.

Background

Methods

Results

Conclusions

Publications

Adaptation of an evidence-based postpartum depression intervention: feasibility and acceptability of mothers and babies 1-on-1.

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