Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial

Abstract

Background Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/Curso Mamás y Bebés, a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD. Methods Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses. Results Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction (b = −0.514, χ2 (1) = 3.43, p = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms (b = −0.605, χ2 (1) = 5.20, p =.023). Conclusions This study provides preliminary evidence that Internet interventions are a promising method toward expanding the reach of psychological resources to perinatal women at-risk for PPD.

Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature

“…Individuals who successfully completed the online programmes frequently experienced benefits including reduction in symptoms of depression and anxiety and improved quality of life. One study 54 aimed at prevention of post-partum depression recruited Spanish-speaking participants from 23 countries, mostly in Latin America. This study showed that online self-help programmes can promote mental wellbeing among individuals residing in both high-income and lower income countries.…”

“…This study showed that online self-help programmes can promote mental wellbeing among individuals residing in both high-income and lower income countries. 54 …”

A proof‐of‐concept pilot randomized comparative trial of brief Internet‐based compassionate mind training and cognitive‐behavioral therapy for perinatal and intending to become pregnant women

“…Research supporting the utility of Internet interventions for PPD prevention and treatment is more limited. Several trials have demonstrated preliminary effectiveness for prevention of PPD (e.g., Barrera, Wickham, & Muñoz, 2015;Haga, Drozd, Brendryen, & Slinning, 2013;Jones et al, 2013) as well as treatment (e.g., Danaher et al, 2012;O'Mahen et al, 2014;O'Mahen et al, 2013). However, additional trials are necessary to better understand both the utility and limitations of Internet interventions for women in the perinatal period who either have or may be at risk of developing PPD.…”

Getting It “Right”

“…Data for this report were extracted from the baseline assessment of a larger trial that examined the efficacy of an online prevention of postpartum depression (PPD) intervention (see Barrera, Wickham, & Muñoz, 2015). Participants were recruited online using sponsored links (see Barrera, Kelman, & Muñoz, 2014) and were directed to the online consent form if they were female, pregnant (at any stage), and over 18 years of age.…”