Six-Month Outcomes from a Randomized Controlled Trial to Prevent Perinatal Depression in Low-Income Home Visiting Clients
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Perinatal depression (PD) has negative consequences for mothers and children and is more prevalent among women of low socioeconomic status. Home visitation programs serve low-income pregnant women at risk for PD. This study tested the efficacy of a group-based cognitive behavioral intervention (Mothers and Babies Course; MB) in reducing depressive symptoms and preventing the onset of perinatal depression among low-income women enrolled in home visitation. A randomized controlled trial was conducted. Seventy-eight women who were pregnant or had a child less than 6 months of age and who were assessed as at risk for PD were randomized to the MB intervention or usual home visiting services. Depressive symptoms were assessed at baseline and 1-week, 3- and 6-months post-intervention; depressive episodes were assessed with a clinical interview at the 6-month follow-up. Depressive symptoms declined at a significantly greater rate for intervention participants than usual care participants between baseline and 1-week, 3 and 6 months post-intervention. At the 6-month follow-up, 15 % of women who received the MB intervention had experienced a major depressive episode as compared with 32 % of women receiving usual care. Integrating mental health interventions into home visitation appears to be a promising approach for preventing PD. Cognitive behavioral techniques can be effective in preventing depression in perinatal populations and treating it.
KeywordsPerinatal depression Depression Prevention Home visiting African American Low-income
The study was funded by a grant (UL1 RR025005) from the National Center for Research Resources (NCRR) at the National Institutes of Health, as part of a consortium of Clinical and Translational Science Awards (CTSA). We would also like to thank the four home visiting programs and their program participants for their strong support of this project.
- 3.Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment No. 119. (Prepared by the RTI-University of North Carolina Evidence-based Practice Center, under Contract No. 290-02-0016). AHRQ Publication No. 05-E006-2. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
- 7.National Research Council and Institute of Medicine. (2009). Depression in parents, parenting and children: opportunities to improve identification, treatment and prevention. Washington, DC: The National Academies Press.Google Scholar
- 8.U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health. Retrieved from: http://www.census.gov/populations/www/cen2000/briefs.html.
- 10.Austin, M. P., Frilingos, M., Lumley, J., Hadzi-Pavlovic, D., Roncolato, W., et al. (2008). Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: A randomised controlled trial. Journal of Affective Disorders, 105, 35–44.PubMedCrossRefGoogle Scholar
- 23.Affordable Care Act. (2010). Maternal, Infant, and Early Childhood Home Visiting Program (P.L. 111–148). Washington, DC.Google Scholar
- 28.Ammerman, R. T., Putnam, F. W., Stevens, J., Holleb, L. J., Novak, A. L., & Van Ginkel, J. B. (2005). In-home cognitive behavior therapy for depression: An adapted treatment for first-time mothers in home visitation. Best Practices in Mental Health, 1, 1–14.Google Scholar
- 29.Beeber, L. S., Holditch-Davis, D., Perreira, K., Schwartz, T. A., Lewis, V., et al. (2010). Short-term in-home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers. Research in Nursing & Health, 33, 60–76.Google Scholar
- 32.Le, H. N., & Muñoz, R. F. (1998). The Maternal Mood Screener (MMS). Unpublished questionnaire, University of California, San Francisco.Google Scholar
- 35.Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
- 36.First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
- 37.Leis, J. A., Tandon, S. D., Perry, D. F., & Mendelson, T. (2009). Perceptions of mental health services among home visiting program participants and staff. Washington, DC: Paper presented at the Society for Prevention Research.Google Scholar
- 38.StataCorp. (2009). Stata Statistical Software: Release 11. College Station, TX: StataCorp LP.Google Scholar
- 42.Duggan, A., Berlin, L., Cassidy, J., Burrell, L., & Tandon, S. (2009). Examining maternal depression and attachment insecurity as moderators of the impacts of home visiting for at-risk mothers and infants. Journal of Consulting and Clinical Psychology, 77, 788–799.PubMedCentralPubMedCrossRefGoogle Scholar