Preventing perinatal depression in low-income home visiting clients: a randomized controlled trial

J Consult Clin Psychol. 2011 Oct;79(5):707-12. doi: 10.1037/a0024895.

Abstract

Objective: To assess the efficacy of a 6-week cognitive-behavioral intervention in preventing the onset of perinatal depression and reducing depressive symptoms among low-income women in home visitation programs.

Method: Sixty-one women who were pregnant or who had a child less than 6 months of age and who were assessed as at risk for perinatal depression were randomized to a 6-week, group-based cognitive-behavioral intervention or usual home visiting services. Study participants were predominately African American, unmarried, and unemployed. Intervention sessions were led by a licensed clinical social worker or clinical psychologist. Home visitors provided 1-on-1 reinforcement of key intervention messages between group sessions. Depressive symptoms were measured with the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996), and major depressive episodes were measured with the Maternal Mood Screener (MMS; Le & Muñoz, 1998). Outcomes were assessed at baseline and at 1 week and 3 months postintervention.

Results: Repeated measures analysis of variance indicated that there was a significant Time × Condition interaction, F(2, 112) = 4.1, p = .02. At 3 months postintervention, 9 of 27 (33%) women receiving usual care reported levels of depressive symptoms that met clinical cutoff for depression on the MMS compared with 3 of 32 (9%) women in the intervention condition, χ²(1, N = 59) = 5.18, p < .05.

Conclusion: This study provides preliminary data on the efficacy of a cognitive-behavioral intervention to prevent perinatal depression among home visiting clients and suggests it is feasible to embed such an intervention in home visitation programs. A larger trial is warranted to attempt to replicate study findings.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • African Americans / psychology
  • Cognitive Behavioral Therapy / methods*
  • Depression / diagnosis
  • Depression / prevention & control*
  • Depression / therapy*
  • Female
  • House Calls
  • Humans
  • Postnatal Care / methods
  • Postnatal Care / psychology
  • Poverty
  • Pregnancy
  • Prenatal Care / methods
  • Prenatal Care / psychology
  • Reinforcement, Psychology
  • Young Adult