Reducing postpartum depressive symptoms among black and latina mothers: A randomized controlled trial

Elizabeth A. Howell, Amy Balbierz, Jason Wang, Michael K. Parides, Caron Zlotnick, Howard Leventhal

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

OBJECTIVE:: To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS:: We recruited 540 self-identified black and Latina mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. Those in the intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participant's access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed before randomization and, 3 weeks, 3 months, and 6 months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS:: Positive depression screens were less common among intervention compared with enhanced usual care posthospitalization: 3 weeks (8.8% compared with 15.3%, P=.03), 3 months (8.4% compared with 13.24%, P=.09), and 6 months (8.9% compared with 13.7%, P=.11). An intention-to-treat repeated-measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression compared with enhanced usual care (odds ratio 0.67, 95% confidence interval [CI] 0.47-0.97; number needed to treat 16, 95% CI 9-112). CONCLUSION:: An action-oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers.

Original languageEnglish (US)
Pages (from-to)942-949
Number of pages8
JournalObstetrics and Gynecology
Volume119
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

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Hispanic Americans
Postpartum Period
Randomized Controlled Trials
Mothers
Depression
Postpartum Depression
Social Support
Confidence Intervals
Numbers Needed To Treat
Self Efficacy
Random Allocation
Length of Stay
Odds Ratio

ASJC Scopus subject areas

  • Medicine(all)

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Reducing postpartum depressive symptoms among black and latina mothers : A randomized controlled trial. / Howell, Elizabeth A.; Balbierz, Amy; Wang, Jason; Parides, Michael K.; Zlotnick, Caron; Leventhal, Howard.

In: Obstetrics and Gynecology, Vol. 119, No. 5, 01.05.2012, p. 942-949.

Research output: Contribution to journalArticle

Howell, Elizabeth A. ; Balbierz, Amy ; Wang, Jason ; Parides, Michael K. ; Zlotnick, Caron ; Leventhal, Howard. / Reducing postpartum depressive symptoms among black and latina mothers : A randomized controlled trial. In: Obstetrics and Gynecology. 2012 ; Vol. 119, No. 5. pp. 942-949.
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N2 - OBJECTIVE:: To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS:: We recruited 540 self-identified black and Latina mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. Those in the intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participant's access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed before randomization and, 3 weeks, 3 months, and 6 months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS:: Positive depression screens were less common among intervention compared with enhanced usual care posthospitalization: 3 weeks (8.8% compared with 15.3%, P=.03), 3 months (8.4% compared with 13.24%, P=.09), and 6 months (8.9% compared with 13.7%, P=.11). An intention-to-treat repeated-measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression compared with enhanced usual care (odds ratio 0.67, 95% confidence interval [CI] 0.47-0.97; number needed to treat 16, 95% CI 9-112). CONCLUSION:: An action-oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers.

AB - OBJECTIVE:: To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS:: We recruited 540 self-identified black and Latina mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. Those in the intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participant's access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed before randomization and, 3 weeks, 3 months, and 6 months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS:: Positive depression screens were less common among intervention compared with enhanced usual care posthospitalization: 3 weeks (8.8% compared with 15.3%, P=.03), 3 months (8.4% compared with 13.24%, P=.09), and 6 months (8.9% compared with 13.7%, P=.11). An intention-to-treat repeated-measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression compared with enhanced usual care (odds ratio 0.67, 95% confidence interval [CI] 0.47-0.97; number needed to treat 16, 95% CI 9-112). CONCLUSION:: An action-oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers.

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