Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 12, 2018
Date Accepted: Mar 29, 2019
(closed for review but you can still tweet)
Using Smartphone-based Psycho-education to Reduce Postnatal Depression Among First-time Mothers: A Randomised Clinical Trial
ABSTRACT
Background:
Smartphone-based psycho-education interventions may be a low-cost, user-friendly alternative to manpower-consuming face-to-face antenatal classes to educate expectant mothers.
Objective:
This study aimed to examine empirically whether such intervention would lead to reduced postnatal depression (PND), anxiety, and stress, and result in a better health-related quality of life (QoL).
Methods:
A single-blind randomised clinical trial was conducted in Hong Kong during 2016 and 2017. All first-time expectant mothers, less than 24 weeks gestation, attending the antenatal clinic at a public hospital were included. Participants were assigned to the intervention and the control groups by the lots prepared by interviewers and randomly assigned to sealed opaque envelopes by stratified randomization. The intervention is a smartphone-based program involving a psycho-educational mobile application provided in addition to the treatment as usual (TAU) services from the hospital. Participants were followed up until 4-week postpartum. The primary outcome was the difference in the levels of pregnancy depression and PND, assessed by the Edinburgh Postnatal Depression Scale (EPDS). The intention-to-treat approach was employed in the analyses.
Results:
The final sample was 660 expectant mothers (nintervention = 330, ncontrol = 330). The mean difference of the EPDS scores between groups was -0.65 (95% CI = -1.29–0.00, p = .049) after adjusting for confounding factors. Associations between participation in the intervention and reduced depression, and attendance in TAU classes and increased stress levels were found.
Conclusions:
This smartphone-based intervention in addition to the TAU services was effective in reducing 4-week PND compared to a control condition of TAU only, validating its effectiveness as a cost-effective alternative to TAU education for expectant mothers. Major limitations included the follow-up assessment at 4 weeks postpartum only, and the inclusion of first-time mothers rather than all mothers. Clinical Trial: HKUCTR.com HKUCTR-2024
Citation
