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

项目摘要 吸烟和抑郁症经常同时发生在孕妇身上。独立地，吸烟和 抑郁症与许多不良出生结果以及对婴儿和儿童的负面影响有关 健康虽然在文献中已经注意到怀孕吸烟者同时发生抑郁症， 在产前或产后戒烟干预研究中没有得到解决。行为激活 已发现BA疗法是治疗孕妇抑郁症的有效方法。在当前 研究，我们将调整现有的BA协议作为抑郁症为重点的干预抑郁症孕妇 吸烟者。在一般吸烟人群中，越来越多的证据表明， 在长期随访中，多次咨询的治疗导致明显更高的禁欲率 与标准疗程相比。基于移动的/互联网的软件的最近发展提供了 通过视频会议提供密集的心理治疗干预的机会， 增加了在产前和产后期间向怀孕吸烟者提供此类干预措施的可行性， 产后时期智能手机应用程序和支持性短信已被证明是一种有效的 辅助改善结果和增加参与者参与面对面心理治疗。 然而，提供心理治疗视频会议和支持性应用程序消息的可行性， 智能手机尚未被评估，也不是延长行为戒烟的可行性， 从产前到产后的抑郁症治疗。在目前的研究中，我们将试点测试 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，以及在怀孕期间为抑郁的怀孕吸烟者提供BA应用程序（BA）。 产前和产后期间;并将进行初步评估BA对禁欲的影响， 产后6个月抑郁症

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.