Accepted for/Published in: JMIR Mental Health
Date Submitted: May 4, 2022
Open Peer Review Period: May 4, 2022 - Jun 29, 2022
Date Accepted: Jan 3, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Efficacy of “Be a Mom”, a Web-based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
ABSTRACT
Background:
Postpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the utilization of web-based intervention programs.
Objective:
The objective of this study was twofold: first, to assess the efficacy of “Be a Mom”, a brief web-based selective/indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high-risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (i.e., emotion regulation, self-compassion and psychological flexibility) to improved perinatal mental health outcomes.
Methods:
This two-arm, open-label randomized controlled trial (RCT) involved a sample of 1058 perinatal women presenting high-risk for PPD, who were allocated to “Be a Mom” intervention group or a waiting-list control group, and completed self-report measures at baseline and post-intervention assessments. Univariate Latent Change Score (LCS) models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup model approach to detect differences between the intervention and the groups, and a two-wave LCS model to examine whether changes in processes were related to changes in outcomes.
Results:
“Be a Mom” was found to be effective in reducing depressive (intervention group: µΔ = -3.35, P<.001 vs. control group: µΔ = -1.48, P<.001) and anxiety symptoms (intervention group: µΔ = -2.24, P<.001 vs. control group: µΔ = -0.43, P=.04), in comparison to the control group where such changes were inexistent or much smaller. All the three psychological processes under study improved significantly in post-treatment assessments: emotion regulation ability (ΔX2(3) = 12.25, P=.007) and psychological flexibility (ΔX2(3) = 34.90, P<.001) improved only in the intervention group, and even if self-compassion increased in both groups (ΔX2(3) = 65.56, P<.001), those improvements were nearly five times greater in the intervention group.
Conclusions:
These results suggest that “Be a Mom”, a low intensity cognitive behavior therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms. Clinical Trial: ClinicalTrials.gov (NCT03024645); https://clinicaltrials.gov/ct2/show/NCT03024645.
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Copyright
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