Effect of exercise and wellness interventions on preventing postpartum depression

描述（由申请人提供）：我们的申请是对PA-09-174“怀孕和产后妇女心理健康”的回应。大约10%到13%的女性患有产后抑郁症（Banti et al., 2011; Gaynes et al., 2005）。心理干预对治疗产后抑郁症是有效的（Dennis & Hodnett, 2009）；然而，预防产后抑郁症优于治疗。研究表明，大多数心理干预措施对预防产后抑郁症无效（Dennis & Creedy, 2008），因此，有必要测试新的和创新的预防策略。研究表明，运动对成人抑郁症的治疗是有效的（例如，Blumenthal et al., 2007; Mead et al., 2009），对于不愿意或不能使用传统治疗方法的产后妇女来说，运动可能是一种理想的干预手段。例如，研究表明，大多数母乳喂养的母亲不愿使用抗抑郁药（Buist等人，2005；Whitton等人，1996）。本研究的目的是探讨运动和健康/支持干预对预防产后抑郁症的效果。具体来说，450名产后久坐（2至6周）且怀孕前有抑郁史的妇女将被随机分为三组：(1)基于电话的运动干预；(2)电话健康/支持干预；或者(3)日常护理。参与者将通过在线、电子邮件和平面广告招募。我们将

DESCRIPTION (provided by applicant): Our application is in response to PA-09-174 "Women's Mental Health in Pregnancy and the Postpartum Period." Approximately 10 to13 percent of women experience postpartum depression (Banti et al., 2011, Gaynes et al., 2005). Psychological interventions are efficacious for treating postpartum depression (Dennis & Hodnett, 2009); however, the prevention of postpartum depression is preferable to treatment. Research indicates that a majority of psychological interventions are not efficacious for preventing postpartum depression (Dennis & Creedy, 2008) and thus, there is a need to test new and innovative prevention strategies. Research indicates that exercise is efficacious for the treatment of depression among adults (e.g., Blumenthal et al., 2007; Mead et al, 2009) and exercise may be an ideal intervention for postpartum women who are not willing or able to use traditional treatments. For example, research indicates that a majority of breastfeeding mothers are reluctant to use antidepressants (Buist et al., 2005; Whitton et al., 1996). The purpose of this study is to examine the efficacy of exercise and wellness/support interventions for preventing postpartum depression. Specifically, 450 sedentary postpartum women (two to six weeks) with a history depression prior to pregnancy will be randomized to one of three groups: (1) telephone-based exercise intervention; (2) telephone-based wellness/support intervention; or (3) usual care. Participants will be recruited via online, email, and print advertisements. We will obtain healthcare provider consent for each participant prior to randomization. The exercise intervention will consist of a theory-based telephone intervention shown to increase exercise among postpartum women in a previous study (Lewis et al., 2011). The wellness/support condition will be on the same schedule as the exercise intervention and will address several topics related to wellness. The primary dependent variable will be depression as measured by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Edinburgh Postnatal Depression Scale (EPDS). Exercise adherence will be assessed using the Seven-Day Physical Activity Recall Interview (Blair et al., 1985; Sallis et al., 1985) and the ActiGraph (i.e, an accelerometer).