Archives of Women's Mental Health

, Volume 13, Issue 4, pp 307–317

Adapting and testing telephone-based depression care management intervention for adolescent mothers

  • M. Cynthia Logsdon
  • Melissa Pinto Foltz
  • Bradley Stein
  • Wayne Usui
  • Allan Josephson
Original Contribution


This phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone-based, depression care management intervention for adolescent mothers and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n = 97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression.


Adolescent mothers Postpartum depression Telephone-based care 


  1. Asbury LD, Wong FL, Price SM, Nolin MJ (2008) The VERB campaign: applying a branding strategy in public health. American Journal of Preventive Medicine 34:183–187CrossRefGoogle Scholar
  2. Beeghly M, Olsen K, Weinberg M, Pierre S, Downey N, Tronick E (2003) Prevalence, stability, and sociodemographic correlates of depressive symptoms in black mothers during the first 18 months postpartum. Maternal and Child Health Journal 7:157–167CrossRefPubMedGoogle Scholar
  3. Brooten D, Kumar S, Brown LP, Butts P, Finkler SA, Bakewell-Sachs S et al (1986) A randomized clinical trial of early hospital discharge and home follow up of very low birth weight infants. New England Journal of Medicine 315:934–939PubMedGoogle Scholar
  4. Cantilino A, Barbosa EM, Petribu K (2007) Postpartum depression in adolescents in Brazil: an issue of concern. Archives of Women’s Mental Health 10(6):1434–1816CrossRefGoogle Scholar
  5. Clemmens D (2002) Adolescent mothers’ depression after the birth of their babies: weathering the storm. Adolescence 37:551–565PubMedGoogle Scholar
  6. Dietrich AJ (2000). The telephone as a new weapon in the battle against depression. Retrieved April 10, 2009 from
  7. Erikson EH (1959) Identity and the life cycle. International Universities Press, New YorkGoogle Scholar
  8. Eshbaugh EM (2006) Predictors of depressive symptomology among low-income adolescent mothers. Archives of Women’s Mental Health 9:339–342CrossRefPubMedGoogle Scholar
  9. Evans WD, Hastings G (2008) Public health branding: applying marketing for social change. Oxford University Press, LondonGoogle Scholar
  10. Field T, Hernandez-Reif M, Vera Y, Gil K, Diego M, Sanders C (2005) Infants of depressed mothers facing a mirror versus their mother. Infant Behavior and Development 28:48–53CrossRefGoogle Scholar
  11. Garrison CZ, Addy A, Jackson KL, McKeown R, Waller JL (1991) The CES-D as a screen for depression and other psychiatric disorders in adolescents. J Am Acad Child Adolesc Psychiatry 30:636–641CrossRefPubMedGoogle Scholar
  12. Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ (2006) Collaborative care for depression: a cumulative meta-analysis and review of longer term outcomes. Archives of Internal Medicine 166:2314–2321CrossRefPubMedGoogle Scholar
  13. Hudson-Scholle S, Kelleher K (2003) Preferences for depression advice among low-income income women. Maternal and Child Health Journal 7(2):1573–6628Google Scholar
  14. Hunkeler EM, Meresman JF, Hargreaves WA, Fireman B, Berman WH, Kirsch AJ et al (2000) Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Archives of Family Medicine 9:700–708CrossRefPubMedGoogle Scholar
  15. Josephson AM (2008) Reinventing family therapy: teaching family intervention as a new treatment modality. Academic Psychiatry 32:405–413CrossRefPubMedGoogle Scholar
  16. Katon W, von Korff M, Lin E, Simon G (2001) Rethinking practitioner roles in chronic illness: the specialist, primary care physician, and the practice nurse. General Hospital Psychiatry 23:138–144CrossRefPubMedGoogle Scholar
  17. Katzelnick DJ, Simon GE, Pearson SD, Manning WG, Helstad CP, Henk HJ et al (2000) Randomized trial of a depression management program in high utilizers of medical care. Archives of Family Medicine 9:345–351CrossRefPubMedGoogle Scholar
  18. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P et al (1997) Schedule for affective disorders and schizophrenia for school age children—present and lifetime version: initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry 36:980–981CrossRefGoogle Scholar
  19. Killeen J (1998) Postpartum return to work: maternal stress, anxiety, and gratification. Canadian Journal of Nursing Research 30:50–63Google Scholar
  20. Kitzman H, Olds DL, Henderson CR Jr, Hanks C, Cole R, Tatelbaum R et al (1997) Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: a randomized clinical trial. Journal of the American Medical Association 278:644–652CrossRefPubMedGoogle Scholar
  21. Koniak Griffin D, Anderson N, Verzmenieks I, Brecht M (2000) A public health nursing early intervention program for adolescent mothers: outcomes from pregnancy through six weeks postpartum. Nursing Research 49:130–138CrossRefPubMedGoogle Scholar
  22. Lincoln Y, Guba E (1985) Naturalistic inquiry. Sage, Newbury ParkGoogle Scholar
  23. Logsdon MC (2002) The postpartum support questionnaire. In: Strickland OL, Dilorio C (eds) Measurement of nursing outcomes, 2nd edn. Springer, New York, pp 199–215Google Scholar
  24. Logsdon MC (2008) Maternal role functioning in adolescents at 12 months postpartum. Women’s Health Care: A Practical Guide for Nurse Practitioners 7:27–32Google Scholar
  25. Logsdon MC, Birkimer JC, Simpson T, Looney S (2005) Postpartum depression and social support in adolescents. Journal of Obstetrics, Gynecology, and Neonatal Nursing 34:46–54CrossRefGoogle Scholar
  26. Logsdon MC, Cross R, Williams B, Simpson T (2004) Prediction of postpartum social support and symptoms of depression in pregnant adolescents: a pilot study. Journal of School Nursing 20:36–42CrossRefPubMedGoogle Scholar
  27. Logsdon MC, Hines Martin V, Rakestraw V (2009a) Barriers to depression treatment in low-income, unmarried, adolescent mothers in a southern, urban area of the United States. Issues Ment Health Nurs 30:451–455CrossRefPubMedGoogle Scholar
  28. Logsdon MC, Usui W, Pinto Foltz M, Rakestraw V (2009b) Intention to seek mental health treatment in adolescent mothers and a comparison group of adolescent girls. Archives of Psychiatric Nursing 23:41–49CrossRefGoogle Scholar
  29. Logsdon MC, Usui W, Birkimer J, McBride AB (1996) The postpartum support questionnaire: reliability and validity. Journal of Nursing Measurement 4:129–142PubMedGoogle Scholar
  30. Lumley J, Austin M, Mitchell C (2004) Intervening to reduce depression after birth: a systematic review of the randomized trials. International Journal of Technology Assessment in Health Care 20:128–144CrossRefPubMedGoogle Scholar
  31. MBaye A, Logsdon MC (2004). Barriers to mental health service use by childbearing adolescents in MetroLouisville: provider and system barriers. Research poster presented at the University of Louisville Undergraduate Research Poster Day, April 2004, Louisville, KentuckyGoogle Scholar
  32. Mercer RT (1985) The process of maternal role attainment over the first year. Western Journal of Nursing 34(4):198–204Google Scholar
  33. Miller L (1998) Depression among pregnant adolescents. Psychiatric Services 49:970PubMedGoogle Scholar
  34. Miller WR, Rollnick S (2002) Motivational interviewing: preparing people for change. Guilford, New YorkGoogle Scholar
  35. Moore M, Krowchuck H (1997) Parent line: nurse telephone intervention for parents and caregivers of children from birth through age five. Journal of the Society of Pediatric Nurses 2:179–184CrossRefPubMedGoogle Scholar
  36. Morse JM (2006) The scope of qualitatively derived clinical interventions. Qualitative Health Research 16:591–593CrossRefPubMedGoogle Scholar
  37. Myers K, Winters NC (2002) Ten year review of rating scales: scales for internalizing disorders. Journal of the American Academy of Child and Adolescent Psychiatry 41:634–659CrossRefPubMedGoogle Scholar
  38. Nadeem E, Lange JM, Miranda J (2008) Mental health care preferences among low-income and minority women. Archives of Women’s Mental Health 11(2):1434–1816CrossRefGoogle Scholar
  39. National Academy of Sciences (2008) Adolescent health services: missing opportunities. Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Health Development, National Research Council. Retrieved April 8, 2009 from
  40. Olds D, Hill P, Robinson J, Song N, Little C (2000) Update on home visiting for pregnant women and parents of young children. Current Problems in Pediatrics 30:107–141CrossRefPubMedGoogle Scholar
  41. Panzarine S, Slater E, Sharps P (1995) Coping, social support, and depressive symptoms in adolescent mothers. Journal of Adolescent Health 17(2):113–119CrossRefPubMedGoogle Scholar
  42. Prescott CA, McArdle JJ, Hishinuma ES, Johnson RC, Miyamoto RH, Andrade NN et al (2004) Prediction of major depression and dysthymia from CES-D scores among ethnic minority adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 37:495–503CrossRefGoogle Scholar
  43. Prochaska J, Velicer WF (1997) Misinterpretations and misapplications of transtheoretical model. American Journal of Health Promotion 12:11–12PubMedGoogle Scholar
  44. Radloff LS, Locke BZ (1986) The community mental health assessment survey and the CES-D scale. In: Weissmann MM, Myers JK, Ross CE (eds) Community surveys of psychiatric disorders. Rutgers University Press, New Brunswick, pp 177–189Google Scholar
  45. Reid V, Meadows-Oliver M (2007) Postpartum depression in adolescent mothers: an integrative review of the literature. Journal of Pediatric Health Care 21(5):289–298CrossRefPubMedGoogle Scholar
  46. Riley AW, Coiro MJ, Broitman M, Colantuoni E, Hurley KM, Bandeen-Roche K, Miranda J (2009) Mental health of children of low-income depressed mothers: influences of parenting, family environment, and raters. Psychiatric Services 60:329–336CrossRefPubMedGoogle Scholar
  47. Roberts RE, Lewinsohn PM, Seeley JR (1991) Screening for adolescent depression: a comparison of depression scales. Journal of American Academy of Adolescent Psychiatry 30:58–66CrossRefGoogle Scholar
  48. Russell CS (1974) Transition to parenthood: problems and gratifications. Journal of Marriage and the Family 102:295Google Scholar
  49. Sandelowski M (2000) Obtaining qualitative and quantitative sampling, data collection, and analysis techniques in mixed methods studies. Research in Nursing & Health 23:246–255CrossRefGoogle Scholar
  50. Schaffer D, Gould M, Brasic J, Ambrosini P, Fisher P, Bird H et al (1983) A children’s global assessment scale (CGAS). Archives of General Psychiatry 40(11):1228–1231Google Scholar
  51. Schumacher KL, Koresawa S, West C, Dodd M, Paul SM, Tripathy D, Koo P, Miaskowski C (2005) Qualitative research contribution to a randomized clinical trial. Research in Nursing & Health 28:268–280CrossRefGoogle Scholar
  52. Shanok AF (2007) Depression and treatment with inner city pregnant and parenting teens. Archives of Women’s Mental Health 10:199–210CrossRefPubMedGoogle Scholar
  53. Simon GE, VonKorff M, Rutter C, Wagner E (2000) Randomized trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care. British Medical Journal 320:550–554CrossRefPubMedGoogle Scholar
  54. Smith J et al (2000) A primary care intervention for depression. The Journal of Rural Health 16:313–323CrossRefPubMedGoogle Scholar
  55. Sword W, Busser D, Ganann R, McMillan T, Swinton M (2008) Women’s care-seeking experiences after referral for post-partum depression. Qualitative Health Research 18(9):1161–1173CrossRefPubMedGoogle Scholar
  56. Van Meijel B, Gamel C, Van Swieten-Duijfjes B, Grypdonck M (2004) The development of evidence based nursing interventions. Journal of Advanced Nursing 48:84–92CrossRefPubMedGoogle Scholar
  57. Verhoff MJ, Casebeer AL, Hilsden RJ (2002) Assessing efficacy of complementary medicine: adding qualitative research methods to the gold standard. The Journal of Alternative and Complementary Medicine 8:275–281CrossRefGoogle Scholar
  58. Wasson J et al (1992) Benefits and obstacles of health status assessment in ambulatory settings: the clinician’s point of view. Medical Care 30:MS42–MS49CrossRefPubMedGoogle Scholar
  59. Weissman MM, Sholomskas D, Pottenger M, Prushoff BA, Locke BZ (1977) Assessing depressive symptoms in five psychiatric patient populations: a validation study. American Journal of Epidemiology 106:203–214PubMedGoogle Scholar
  60. Whittemore R, Grey M (2002) The systematic development of nursing interventions. Journal of Nursing Scholarship 34:115–120CrossRefPubMedGoogle Scholar
  61. Wilcox H, Field T, Prodromidis M, Scafidi F (1998) Correlation between BDI and CES-D in a sample of adolescent girls. Adolescence 33:565–574PubMedGoogle Scholar
  62. Wisner KL, Scholle SH, Stein B (2008) Perinatal disorders: advancing public health opportunities. J Clin Psychiatry 69(10):1602–1605CrossRefPubMedGoogle Scholar
  63. York R, Brown LP, Samuels P, Finkler SA, Jacobsen B, Persely CA et al (1997) A randomzied controlled trial of early discharge and nurse specialist transitional follow up care of high risk childbearing women. Nursing Research 40:254–261CrossRefGoogle Scholar
  64. Zanjani F, Miller B, Turiano N, Ross J, Oslin D (2008) Effectiveness of telephone-based referral care management, a brief intervention to improve psychiatric treatment engagement. Psychiatric Services 59:776–781CrossRefPubMedGoogle Scholar
  65. Zittel-Palamara K, Rockmaker JR, Schwabel KM, Weinstein WL, Thompson SJ (2008) Desired assistance versus care received for postpartum depression: access to care differences by race. Archives of Women’s Mental Health 11(2):1434–1816CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • M. Cynthia Logsdon
    • 1
  • Melissa Pinto Foltz
    • 2
  • Bradley Stein
    • 3
  • Wayne Usui
    • 1
  • Allan Josephson
    • 1
  1. 1.University of LouisvilleLouisvilleUSA
  2. 2.Case Western Reserve UniversityClevelandUSA
  3. 3.University of Pittsburgh Medical CenterPittsburghUSA

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