Pilot Study to Evaluate a Behavioral Activation Prenatal and Postpartum Intervention for Depressed Pregnant Smokers

项目总结 吸烟和抑郁症经常同时出现在孕妇身上。独立地，吸烟和 抑郁症与许多不利的分娩结局和对婴儿和儿童的负面影响有关 健康。尽管在文献中已经注意到怀孕吸烟者中抑郁的共同发生，但它 在产前或产后戒烟干预研究中没有得到解决。行为激活 治疗(BA)已被发现是治疗孕妇抑郁症的有效方法。在当前 研究表明，我们将采用现有的BA方案作为针对抑郁孕妇的抑郁干预方案 吸烟者。在普通吸烟者中，有越来越多的证据表明，延长疗程 在长期随访中，多次咨询治疗可显著提高禁酒率 与标准治疗疗程相比。基于移动/互联网的软件的最新发展提供 通过视频会议提供密集的心理治疗干预的机会，这可能 增加了在产前和产后向怀孕吸烟者提供此类干预的可行性 产后期。智能手机应用程序和支持性短信被证明是一种有效的 用于改善结果和增加参与者对面对面心理治疗的参与度的辅助工具。 然而，通过以下方式提供心理治疗视频会议和支持性应用程序消息的可行性 智能手机尚未进行评估，也没有延长行为戒烟和 抑郁症的治疗从产前到产后都是已知的。在目前的研究中，我们将试行测试 并评估提供基于智能手机、视频会议的BA治疗的可行性和可接受性 加上行为戒烟咨询，以及为抑郁的怀孕吸烟者提供BA应用程序(BA) 产前和产后期；并将对BA在节欲和产后的影响进行初步评估 产后6个月抑郁。

PROJECT SUMMARY Smoking and depression frequently co-occur in pregnant women. Independently, both smoking and depression are associated with numerous adverse birth outcomes and negative impacts on infant and child health. Although the co-occurrence of depression in pregnant smokers has been noted in the literature, it has not been addressed in prenatal or postpartum smoking cessation intervention studies. Behavioral activation therapy (BA) has been found to be an effective treatment for depression in pregnant women. In the current study, we will adapt an existing BA protocol as a depression-focused intervention for depressed pregnant smokers. In the general population of smokers, there is accumulating evidence that extended courses of treatment with multiple counseling sessions result in significantly higher abstinence rates at long-term follow-up compared to standard treatment courses. The recent development of mobile/internet based software provides opportunities to deliver intensive, psychotherapeutic interventions via videoconferencing, which potentially increases the feasibility of providing such interventions to pregnant smokers across the prenatal and postpartum periods. Smartphone apps and supportive text messaging have been shown to be an effective adjunct for improving outcomes and increasing participant engagement in in-person psychotherapy treatments. However, the feasibility of providing psychotherapeutic videoconferencing plus supportive app messaging via smartphone has not yet been evaluated, nor is the feasibility of extending behavioral smoking cessation and depression treatments from the prenatal to postpartum periods known. In the current study, we will pilot test and evaluate the feasibility and acceptability of providing smartphone, videoconferencing-based BA treatment plus behavioral smoking cessation counseling, and a BA app (BA) to depressed pregnant smokers during the prenatal and postpartum periods; and will conduct a preliminary evaluation of BA’s effect on abstinence and depression at 6 months postpartum.