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Coach-Supported Web-Based Intervention for Mild to Moderate Postpartum Depression

The American College of Obstetricians and Gynecologists (ACOG) now recommends screening for perinatal depression and anxiety, stating that “clinicians screen patients no less than once through the perinatal period for depression and anxiety symptoms using a normal, validated tool.” Roughly 40 states have instituted guidelines and proposals regarding screening for perinatal depression.  

Despite existing screening and treatment recommendations, many ladies don’t receive adequate take care of perinatal mood and anxiety disorders. Quite a few barriers may prevent effective care, including but not limited to delayed or missed screening at primary care appointments, failure to seek out and/or follow up with specially trained clinicians, and understaffed mental health facilities with long waitlists. Thus, there may be an urgent must develop and implement effective and scalable interventions for girls with perinatal mood and anxiety disorders.

The HealthyMoms Online Program

A recent study looks on the feasibility and acceptability of a web-based intervention (HealthyMoms) for the treatment of ladies with mild to moderate postpartum depression (PPD). HealthyMoms is a secure psychoeducational e-health platform consisting of 19 self-guided learning modules specializing in emotional health, healthy living, mental fitness tools, and parenting. The HealthyMoms modules are grounded in cognitive-behavioral therapy (CBT) and mindfulness-based practices.

In a pilot randomized controlled trial (RCT), researchers enrolled women who had recently given birth and had mild to moderate postpartum depression and/or anxiety. Edinburgh Postnatal Depression Scale (EPDS) scores were between 10 and 19; scores on the Generalized Anxiety Disorder-7 scale (GAD-7) were above 10. All study participants were provided access to the web-based intervention. Women randomized to the intervention group also received as much as seven coaching phone calls through the six months of follow up. 

Coaching sessions were provided by women with bachelor’s degrees in psychology and/or experience in community organizations. The coaches were trained to supply information on the intervention, to listen reflectively, and to convey empathy to participants. The foremost goal of the coaching calls was to guide and encourage use of the web-based intervention and to advertise the event of “SMART” (specific, measurable, achievable, realistic, time-limited) goals. 

The study recruited 52 participants who were randomized to intervention (n=25) or the control group (n=27). At 6 months, 88% (22/25) of the participants within the intervention group and 59% (16/27) of the participants within the control group remained within the study. The intervention group had a median of 11 more website logins than the control group. Intervention group participants accomplished a mean of 6.2 coaching calls. 

Since the study was small in size, estimates of the effect of the intervention on depression and anxiety at six months were imprecise; nonetheless, point estimates and confidence intervals were consistent with a moderate useful effect of the intervention on each depressive symptoms and anxiety with fully adjusted effects sizes of 0.51 and 0.56, respectively.

On this pilot RCT, the HealthyMoms web-based intervention accompanied by as much as seven short telephone calls by a trained lay coach was a feasible, acceptable, and potentially effective intervention for girls with mild to moderate postpartum depression and/or anxiety. The addition of coaching calls markedly increased engagement with the web intervention, but larger trials are needed to find out the effectiveness of this form of intervention.

Ruta Nonacs, MD, PhD

Schwartz H, McCusker J, Da Costa D, Singh S, Baskaran S, Belzile E, Van Roost K.  A pilot randomized controlled trial of a lay telephone coaching and web-based intervention for postpartum depression and anxiety: The MPOWER study.  Web Interv. 2022 Dec 23;31:100597.

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