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:BackgroundPostpartum depression and anxiety are the 2 most common perinatal mental health disorders, with prevalence rates higher among women living in the Middle East than in most Western countries. The negative outcomes associated with postpartum depression and anxiety are profound and include less responsive parenting and compromised infant and young child development. Although interventions exist to prevent postpartum depression and anxiety, to date, there have been no studies that have attempted to prevent postpartum depression or anxiety among Arabic-speaking women in the Middle East, including Qatar.ObjectiveThe purpose of this study is to conduct a randomized controlled trial (RCT) of an evidence-based postpartum depression preventive intervention-Mothers and Babies (MB)-culturally adapted for use with Arabic-speaking women in Doha, Qatar. MB is guided by a cognitive behavioral therapy framework that focuses on increasing pleasant activities, promoting healthy thought patterns, and increasing the type and frequency of personal contacts. MB is tailored to specific needs and issues related to pregnancy and the postpartum period.MethodsA multidisciplinary and multiethnic investigator team adapted MB to promote cultural and contextual fit for Arabic-speaking women. Intervention concepts were reviewed to ensure core content would be understood by Arabic-speaking women in Qatar. Subsequently, images, activities, and examples in the intervention manuals were adapted, as needed, to make the content more relevant to Arab culture. To deliver the adapted intervention, 30 Arabic-speaking individuals with mental health backgrounds were trained. The adapted intervention was subsequently pilot-tested with 10 pregnant women receiving prenatal care at Sidra Hospital in Doha. We are now conducting an RCT to examine the effectiveness of the adapted intervention. We plan to enroll 210 pregnant individuals who are Arabic-speaking, with 1:1 randomization to the MB intervention or usual prenatal care. Among the enrolled participants, a stratified subsample of 40 pregnant women with diabetes is being recruited. Data collection will take place at baseline and a 6-month follow-up. The primary outcomes are depressive and anxiety symptoms and perceived stress. Diabetes self-care is the exploratory outcome for the subsample of individuals with diabetes. Intervention implementation will be assessed via client and provider surveys during and after intervention delivery. Power and sample size were calculated using a 2-sided 5% effort rate and assumed analyses on the individual level, accounting for attrition of 20%.ResultsThe cultural adaptation and pilot study of the adapted MB intervention are completed. A total of 157 women have been enrolled in the RCT as of March 31, 2023.ConclusionsThis study is highly innovative, as it is the first study to our knowledge to examine the effectiveness of an evidence-based postpartum depression preventive intervention in the Middle East. Limitations include a single follow-up time point and a small subsample of individuals with diabetes.Trial registrationClinicalTrials.gov NCT04442529; https://www.clinicaltrials.gov/study/NCT04442529.International registered report identifier (irrid)DERR1-10.2196/11623.

Project description:BackgroundMental disorders during pregnancy and the postpartum period can have far-reaching consequences. To enhance peripartum mental well-being and prevent peripartum mental disorders, internet- and mobile-based interventions appear promising. They can overcome help-seeking barriers associated with face-to-face conditions and have proven to be effective. However, previous findings are scarce and mixed. The primary objectives of this study were to assess the feasibility and acceptability of an internet-based program aimed at enhancing peripartum mental well-being and preventing postpartum depression.MethodsIn total, 149 pregnant, German-speaking women were assigned to the internet-based intervention PandaMom. The program comprises a total of 10 basic and supplementary modules related to pregnancy and postpartum, based on cognitive-behavioral principles. Additionally, PandaMom offers professional, individualized guidance and a moderated group-chat. Assessments were conducted at baseline (pre-intervention), as well as two and five weeks postpartum. The primary outcomes included feasibility, user satisfaction, and adherence to the intervention. Secondary outcomes included depressive symptomatology, anxiety and stress.ResultsPandaMom was found to be feasible, and evaluation of module content and length satisfaction indicated that the intervention was well accepted. Nearly half of the participants utilized the guidance service by responding to individual messages from their intervention moderator. Regarding working alliance, participants reported a strong bond with their intervention moderator. Of the 149 participants, 132 logged into the platform at least once. 113 participants accessed at least one module, with an average of 4.7 modules opened per participant. However, only 16 participants completed the basic modules.ConclusionThe findings of this study support previous evidence that internet-and mobile-based interventions are feasible and acceptable during pregnancy and the postpartum period. Further research is needed to address the challenge of low adherence and to evaluate the efficacy of PandaMom.

Project description:BackgroundPostpartum 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.ObjectivesThis 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.MethodsUser-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.ResultsA 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.ConclusionsResults 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 registrationClinicalTrials.gov NCT02121015; https://clinicaltrials.gov/ct2/show/NCT02121015 (archived by WebCite at http://www.webcitation.org/765a7qBKy).

Project description:ObjectiveTo assess the feasibility of the family paediatrician's (FP) role in identifying the signs of postpartum depression in parents in time to guarantee child well-being.Design, setting and participantsData for this observational prospective study were collected within the NASCITA (NAscere e creSCere in ITAlia) cohort. During the first visit, paediatricians collected sociodemographic data regarding the parents and information about their health status, the pregnancy and the delivery. Whooley questions were administered during the first and second visits (scheduled 60-90 days after childbirth). Moreover, on the third visit (5-7 months after childbirth) the FP was asked to answer 'yes' or 'no' to a question on the parental postpartum depression, based on his knowledge and on the acquired information.ResultsIn 2203 couples who completed the assessment, 529 mothers (19.9%), 141 fathers (6.3%) and 110 (5%) couples reported any depressive symptomatology. Of these, 141 mothers (5.3% of the total sample) and 18 fathers (0.8% of the total sample) were classified as 'likely depressed'. An association was found between maternal postnatal depressive symptoms and having a diagnosed psychiatric disorder during pregnancy (OR 9.49, 95% CI: 3.20 to 28.17), not exclusively breastfeeding at hospital discharge (OR 1.76, 95% CI: 1.19 to 2.61) and the presence of child sleeping disorders at 3 (OR 2.46, 95% CI: 1.41 to 4.28) and 6 months (OR 2.18, 95% CI: 1.37 to 3.47). Another significant predictor of postpartum depression was being primiparous (OR 1.99, 95% CI: 1.31 to 3.02). Concerning the fathers, a significant association was reported only between likely depressed fathers and child sleeping disorders at 3 months (OR 7.64, 95% CI: 2.92 to 19.97). Moreover, having a likely depressed partner was strongly associated with depressive symptoms in fathers (OR 85.53, 95% CI 26.83 to 272.69).ConclusionsThe findings of this study support the feasibility of an active screening programme for parental postnatal depression during well-child visits as an integral part of postpartum care.Trial registration numberNCT03894566; Pre-results.

Project description:IntroductionPostpartum depression (PPD) affects around one in seven women globally, with these women in need of non-pharmaceutical treatment strategies. There is a long history of the benefits of singing for maternal mental health, and promising research exists showing the clinical effectiveness of group singing. Group singing interventions are being scaled up to support new mothers in the United Kingdom, but we do not know if such an intervention may benefit women in different cultural contexts. This protocol focuses on exploring the feasibility of implementation and perceived impact of a 10-week group singing intervention for new mothers in Romania and Denmark eliciting signs of PPD.Methods and analysisData will be collected from up to 48 women with a score ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) participating in a 10-week group singing intervention in Denmark or Romania, as well as a range of project stakeholders. The singing classes will take place in person and be facilitated by professional singing leaders. Feasibility of implementation will be analysed through qualitative data (eg, focus groups, interviews) and quantitative data (eg, the Feasibility of Intervention Measure). Perceived impact will be explored via surveys that include mental health measures (EPDS, Multidimensional Scale of Perceived Social Support, WHO Five Well-Being Index) from singing intervention participants (at weeks 1, 6, 10) and focus groups. Descriptive statistics, repeated measures analysis of variance and analysis of covariance will be used to analyse quantitative data. Framework method and thematic analysis will be used to analyse qualitative data.Ethics and disseminationThe national ethics committees in Romania (IRB-PH Protocol #2021-211217-012) and Denmark (case number 1-10-72-274-21) have approved the study, as has the Ethics Review Committee at the World Health Organization (ERC.0003714). All participants will be required to provide informed consent. Results will be disseminated by reports published by the WHO Regional Office for Europe, peer-reviewed publications and at conferences.

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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