Efficacy of an Internet-based depression intervention to improve rates of treatment in adolescent mothers

Abstract

Approximately 400,000 adolescents give birth in the USA annually. Although one-half experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment. The current study tested the effectiveness of an Internet-based depression intervention on seeking depression treatment. Based upon the theory of planned behavior (TPB), the intervention included vignettes, questions and answers, and resources. Before the intervention, immediately after the intervention, and 2 weeks later the adolescent mothers (n = 151) answered questions related to TPB variables and depression treatment. Data were compared to adolescent mothers (n = 138) in the control group. Data were collected in community organizations or home visits for the control group. Adolescent mothers in the intervention group answered questions and completed the intervention from a computer of their choice. The adolescents were primarily African American (89.2%), less than high school educated (51.7%), had given birth in last year (97.1%), with a mean age 18.2 years. The intervention led to significant changes in attitude, perceived control, intention to seek mental health treatment, and actually seeking depression treatment. Untreated postpartum depression dramatically impacts a mother's relationship with her child, her functioning at work and school, health care-seeking behaviors, mothering skills, and her development as well as the development of her child. An Internet-based depression intervention is an inexpensive method to increase rates of depression treatment.

Is Digital Treatment the Holy Grail? Literature Review on Computerized and Blended Treatment for Depressive Disorders in Youth

“…Table 1 presents details of the included studies (k = 33). Sixteen studies were aimed at computerized treatments, of which nine were unguided computerized treatments (four computer-based and five internet-based) [30][31][32][33][34][35][36][37][38] and seven studies were guided computerized treatments (one computer-based and six internet-bases) [39][40][41][42][43][44][45], two studies at blended treatment [46,47], two studies compared unguided computerized, blended-and face-to-face treatment to no treatment [48,49], and eight studies were aimed at self-help internet-based games [50][51][52][53][54][55][56][57]. Furthermore, two studies that were focused on the use of an online monitoring tool aimed at registering and monitoring treatment progression [58,59] and three studies were aimed at characteristics of online interventions or studied the preferred modes of help seeking [60][61][62].…”

“…Fourteen studies were mainly focused on the evaluation of the effects of the intervention. In these studies, the designs varied between randomized controlled trials (k = 10) [34][35][36]38,39,44,45,49,52,57], pre-post designs with control group (k = 2) [33,42], and pre-post designs without control group (k = 2) [30,40]. Sixteen studies were mainly focused on the feasibility, usability, and acceptability of computerized and blended interventions.…”

“…The evidence shows that participants who received unguided computerized CBT (cCBT) less often showed a depressive disorder after receiving the intervention than before [30]. Further, participants showed an increase in perceived control after receiving unguided cCBT [33]. When unguided cCBT was compared to a wait list condition, the findings showed that depressive symptoms decreased significantly more in the unguided CBT condition [34].…”

“…Indeed, it was found that depressed adolescents are more inclined to avoid seek help than to get face-to-face or computerized treatment [60]. After following an unguided computerized program for depression, adolescents are more intended to seek additional mental health treatment [33,60]. Higher mental health literacy indirectly predicted the intention to seek computerized or face-to-face treatment.…”

“…Participants that used unguided cCBT rated the program as useful and helpful [32]. Most of the participants would recommend it to others [33,36]. One study asked participants to rate the actual website.…”