Strongest Families™ Managing Our Mood (MOM): a randomized controlled trial of a distance intervention for women with postpartum depression
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The present study investigated whether a distance-delivered intervention could significantly decrease mild to moderate postpartum depression (PPD) in mothers as compared to usual care. Mothers with PPD (n = 62) were randomly assigned to the intervention or standard community care. Participants receiving the intervention followed a 12-session cognitive behavioural informed handbook supplemented with telephone-based coaching support. Diagnostic status and depressive symptoms were assessed at baseline and 3, 6 and 12 months postrandomization. Odds ratios indicated that intervention group participants were 1.5 times as likely to experience diagnostic remission at 3 months (mid-intervention) (p = 0.742), 1.54 times as likely at 6 months (p = 0.696) and 12.5 times as likely at 12 months (p = 0.009). Intervention ‘dosage’ significantly moderated this effect; for every additional coaching session completed, individuals had a 1.4 times greater chance of showing improvement at 3 and 6 months. Mothers reported high satisfaction with the intervention. Findings suggest positive outcomes at each time point and superior outcomes to the control condition at the long-term follow-up. Caution in interpreting these results is warranted due to small sample size and incomplete data; however, they support further investigation into the use of distance interventions as an accessible and effective solution for women with PPD.
KeywordsPostpartum depression Randomized controlled trial Telehealth Cognitive behavioural intervention Health care access
The authors would like to thank the following individuals for their significant contributions to the advisory committee: Cathy Thurston, Helen Gould, Kathy Inkpen, Lee Johnson, Jenny MacCormick, Marilyn Martin, Nancy Thurston, Karen Blanchard, Anne MacKenzie, Lisa MacRae, Darla MacPherson, Kim MacClellan, Michelle Pickles, Christine Saulnier, Kim Barro and Liz MacKay. We thank the study staff. We sincerely thank all referring health professionals from across Nova Scotia’s health regions and, most importantly, all mothers who volunteered their valued time to participate.
PJ-M and P-LP conceived of the study and developed the background, methods and design. LM-W and J-O drafted the manuscript and critically revised it for important intellectual content. K-T provided overall trial management and staff supervision and provided substantial revision to the content of the manuscript. W-C and B-C conducted statistical analysis and drafted the main results. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
Dr. McGrath is a volunteer Chair of the Board and Dr. Lingley-Pottie and Jillian Kennedy are paid employees of the Strongest Families Institute, a not-for-profit organization. Dr. Lingley-Pottie’s academic time on this study was in-kind.
The study was funded by the Women’s Health in Rural Communities (WHIRC) research program funded by the Canadian Institutes of Health Research (CIHR; Funding Reference Number 70789).
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