Depressed Mothers in Rural Areas: Web-Facilitated Cognitive Behavioral Treatment



Status:Completed
Conditions:Depression
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:Any
Updated:1/14/2018
Start Date:September 2012
End Date:April 2017

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Low income mothers of young children represent a disadvantaged group who are at exceptional
risk for depressive syndromes and who have increasingly limited access to mental health
services. The proposed project is designed to evaluate Mom-Net, an internet-facilitated
cognitive-behavioral(CBT) intervention for depression, adapted from Lewinsohn's Coping with
Depression Course, and tailored to mothers of young children. Mom-Net, which was developed
and piloted in an recently completed NIMH-funded investigation (MH070426), was designed to
overcome the substantial barriers to treatment participation that exist for mothers
experiencing economic hardship and those in rural communities. Though the pilot trial
demonstrated that the program was very effective in reducing depressive symptoms and related
difficulties, it was conducted under the 'idealized' conditions typical of initial
intervention tests (e.g., computers and internet connections were supplied to all
participants; access to the internet was provided by a single browser; coaches who provided
weekly phone support were research staff, and initial recruitment and motivational interviews
sessions were conducted via home visits to participants). These conditions likely facilitated
recruitment and retention of participants, as well as ease and fidelity of treatment
delivery. Thus one goal of the current project is to evaluate the intervention under
conditions that are closer to those of real-world service providers and recipients. The
current project is also intended to provide a more rigorous test of the intervention than did
the pilot in a number of ways. Participants in the pilot trial will be 300 mothers of 3-5
year old children recruited through Head Start classrooms and prescreened for the presence of
elevated depressive symptoms.Subsequent to the pre-intervention assessment, participants will
be randomized to either the intervention or facilitated usual care (FUC) condition. The
evaluation of the intervention will focus on maternal depressive symptoms, parenting
behavior, and child adjustment. Two follow-up assessments (at 12-month and 24-month
intervals) will enable us to examine maintenance of effects. Overall, the investigation will
contribute to the evidentiary base regarding the dissemination potential of this
empirically-supported intervention, adaptations to which have the potential to enable a
greater proportion of the population to access and benefit from it.

The project is designed to evaluate Mom-Net, an internet-facilitated cognitive-behavioral
(CBT) intervention for depression, adapted from Lewinsohn's Coping with Depression Course,
and tailored to mothers of young children. Mom-Net, which was developed and piloted in a
recently completed NIMH-funded investigation (MH070426), was designed to overcome the
substantial barriers to treatment participation that exist for mothers experiencing economic
hardship and those in rural communities. Though the pilot trial demonstrated that the program
was very effective in reducing depressive symptoms and related difficulties, it was conducted
under the 'idealized' conditions typical of initial intervention tests (e.g., computers and
internet connections were supplied to all participants; access to the internet was provided
by a single browser; coaches who provided weekly phone support were research staff, and
initial recruitment and motivational interviews sessions were conducted via home visits to
participants). These conditions likely facilitated recruitment and retention of participants,
as well as ease and fidelity of treatment delivery. Thus one goal of the current project is
to evaluate the intervention under conditions that are closer to those of real-world service
providers and recipients. The current project is also intended to provide a more rigorous
test of the intervention than did the pilot in a number of ways. Participants in this project
will be 300 mothers of 3-5 year old children recruited through Head Start classrooms and
prescreened for the presence of elevated depressive symptoms. Subsequent to the
pre-intervention assessment, participants will be randomized to either the intervention or
facilitated usual care (FUC) condition. The evaluation of the intervention will focus on
maternal depressive symptoms, parenting behavior, and child adjustment. Two follow-up
assessments (at 12-month and 24-month intervals) will enable us to examine maintenance of
effects. Overall, the investigation will contribute to the evidentiary base regarding the
dissemination potential of this empirically-supported intervention, adaptations to which have
the potential to enable a greater proportion of the population to access and benefit from it.

Inclusion Criteria:

- Mother of 3-5 year old child(ren)

- Reside in rural community, as defined by RUCA

- Meet DSM IV criteria for major or minor depression based on PHQ-9

Exclusion Criteria:

- Cannot comprehend spoken English

- Being treated for depression at intake
We found this trial at
2
sites
Eugene, Oregon 97401
Phone: 541-687-6983
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Eugene, Oregon 97403
Phone: 541-484-2123
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Eugene, OR
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