Online Collaborative Learning Intervention to Prevent Perinatal Depression



Status:Completed
Conditions:Depression, Depression
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:2/3/2018
Start Date:May 2016
End Date:November 2017

Use our guide to learn which trials are right for you!

The overarching aim of this project is to develop and pilot an innovative online intervention
(Share) that integrates an Individual Internet Intervention (III) and an Internet Support
Group (ISG) in preventing Postpartum Major Depression (PPMD). To establish that supportive
accountability is a critical component of the intervention, Share will be compared to an III
alone, and an ISG without the III components.

Postpartum major depression (PPMD) occurs in approximately 7% of women in the first three
months after childbirth and up to 22% of women over the first year postpartum. The impact of
PPMD can be profound, including emotional distress, impairment in daily functioning and
especially in caring for an infant for women as well as disturbances in infant development.
The need for preventive interventions that are effective and widely accessible is clear and
widely recognized.

While several psychological interventions to prevent PPMD have demonstrated efficacy, all of
these interventions require women to be physically present at a treatment site at a
particular time and day. There are numerous well established access barriers to traditional
face-to-face psychological interventions, particularly for postpartum women facing the
demands of childcare, including cost, transportation barriers, and time constraints, all of
which make it impossible for the vast majority of women to participate in preventive care.
The Internet offers great potential in extending mental health services to perinatal women
because it directly circumvents these barriers.

Two broad classes of internet interventions have been evaluated within medicine generally,
although to date there are no published evaluations of such interventions among perinatal
women: Individual Internet Interventions (IIIs), which provide patients with access to
web-based self-management programs, and Internet Support Groups (ISGs), which are usually
centered around a discussion board or chat room. Meta-analyses suggest that IIIs are
effective with acutely depressed patients when they include regular support by live coach
(d=.61), but are much less effective when they are provided as a stand-alone treatment
(d=.25). The enhanced efficacy of coach-supported IIIs appears to be due to the greater
adherence to the intervention (e.g. more frequent usage) resulting from personal coach
contact. The obvious drawbacks are cost and scalability: infrastructures for the training,
oversight and payment of coaches must be implemented.

In contrast, ISGs provide a vehicle for peer support, and are very highly valued and commonly
used by perinatal women. However, while adherence may be good, trials have found unmoderated
ISGs to be ineffective at reducing distress and depression, Taken together, the efficacy of
the IIIs and the adherence, flexibility, and potential for peer support in an ISG suggest
that peers in a well-constructed ISG that encourages support and collaborative learning,
could enhance adherence and outcomes of online self-management training programs. Learning
these self-management skills have proven effective in face-to-face interventions to prevent
depression among perinatal women.

This intervention, which we call "Share", is based upon a unique combination of two critical
concepts:

1. the capacity of IIIs to teach self-management skills; and

2. the potential for ISGs to enhance adherence and contribute to effective learning.

Inclusion Criteria:

Women who are:

1. 18 years and older

2. Pregnant and between 20 and 28 weeks gestation and for whom there is an expectation of
a full 40 week gestation at the birth of their child

3. Have a Patient Health Questionnaire (PHQ-9) score score between 5-14

4. Have access to a broadband internet connection

5. Are able to read and speak English

Exclusion Criteria:

Women who:

1. Have visual, hearing, voice, or motor impairment that would prevent completion of
study procedures

2. Are diagnosed with a psychotic disorder, bipolar disorder, dissociative disorder,
substance use disorder or other diagnosis using the Mini International
Neuropsychiatric Interview (MINI) for which participation in this trial is either
inappropriate or dangerous

3. Are currently receiving treatment (medication or psychotherapy), or have an intention
to resume antidepressant medication after delivery (i.e., women who discontinued their
medication during pregnancy)

4. Are suicidal (i.e., have ideation, plan, and intent)
We found this trial at
3
sites
101 Jessup Hall
Iowa City, Iowa 52242
(319) 335-3500
University of Iowa With just over 30,000 students, the University of Iowa is one of...
?
mi
from
Iowa City, IA
Click here to add this to my saved trials
303 East Superior Street
Chicago, Illinois 60611
?
mi
from
Chicago, IL
Click here to add this to my saved trials
2035 W Taylor St
Chicago, Illinois
(312) 996-4350
University of Illinois at Chicago A major research university in the heart of one of...
?
mi
from
Chicago, IL
Click here to add this to my saved trials