Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial.
Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial.
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DOI：
10.1016/j.invent.2015.06.002
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发表时间：
2015-09-01
期刊：
影响因子：
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通讯作者：
Munoz, Ricardo F
中科院分区：
文献类型：
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作者：
Barrera, Alinne Z;Wickham, Robert E;Munoz, Ricardo F
背景：产后抑郁症（PPD）是一种影响世界各地妇女的孕产妇心理健康问题。不幸的是，即使在发达国家，也有一半的病例未被发现，因此得不到治疗。来自低收入和中等收入国家的个人倾向于对心理健康服务的利用不足，部分原因是可用的心理资源数量有限。这项试点随机对照试验的主要目的是适应互联网母婴课程/Curso Mamas y Bebes，预防PPD干预，描述参与干预网站的孕妇的特征，并获得关于互联网干预降低PPD风险的疗效的初步数据。方法：18岁或18岁以上有兴趣自己使用该网站的孕妇被招募并随机分配到全自动自助互联网干预或仅信息控制条件。随机参与者被邀请完成产后六个月的每月抑郁症评估。为了检验互联网干预的预防效果，研究分析中纳入了不符合当前重度抑郁发作标准的孕妇、参与研究网站的孕妇以及在产后随访期间提供抑郁数据的孕妇。参与者是111名主要讲西班牙语（82.9%）和拉丁美洲/西班牙裔（71.3%）的孕妇，居住在全球23个国家。预防干预条件的效果在先验α水平上未能达到显著性。然而，观察到的系数倾向于假设的方向（B =-0.514，chi 2（1）= 3.43，p = 0.061; HR = 0.598）。接受e-MB互联网干预的好处是更大的孕妇报告高（与低）水平的产前抑郁症状（B =-0.605，chi 2（1）= 5.20，p = 0.023）。结论：这项研究提供了初步证据，互联网干预是一个有前途的方法，扩大心理资源的范围，以围产期妇女的PPD风险。
BACKGROUND: Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/Curso Mamas y Bebes, a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD.METHODS: Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses.RESULTS: Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction (b = -0.514, chi2 (1) = 3.43, p = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms (b = -0.605, chi2 (1) = 5.20, p =.023).CONCLUSIONS: This study provides preliminary evidence that Internet interventions are a promising method toward expanding the reach of psychological resources to perinatal women at-risk for PPD.