Division of Social and Behavioral Interventions, Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD 21205-2103, USA.
Matern Child Health J. 2012 Jan;16(1):139-48. doi: 10.1007/s10995-010-0729-x.
Given that diet, physical activity, and social support are associated with depression, we examined whether a health promotion intervention designed to modify these factors in low-income, postpartum women would reduce depressive symptoms. This study used a randomized, controlled design to examine the effect of the Just for You (JFY) Program, an educational intervention promoting healthy lifestyles through home visits by nutrition paraprofessionals and motivational telephone counseling, on postpartum depressive symptoms. A total of 679 women income-eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were recruited at 6-20 weeks post delivery and randomized to Usual WIC Care or JFY. Using an intention-to-treat analysis, the authors modeled depressive symptoms on the Center for Epidemiologic Studies Depression Scale (CES-D) among 403 women (59%) completing follow-up at a mean of 15 months infant age, adjusting for baseline CES-D, age, household income and randomization strata (body mass index (BMI), race/region). As a secondary analysis, the authors evaluated potential mediators related to social support and self-efficacy to change one or more health behaviors targeted by the intervention. Women randomized to JFY reported 2.5 units lower CES-D score (P = 0.046) compared with those receiving Usual WIC Care alone. This relationship was attenuated by change in self-efficacy (β = -2.3; P = 0.065), suggesting this construct may partially have mediated the effect of JFY on maternal depressive symptoms. A health promotion intervention delivered through home visits and telephone calls can reduce depressive symptoms at 15 months postpartum among low-income, ethnically diverse women.
鉴于饮食、身体活动和社会支持与抑郁有关，我们研究了旨在改变低收入、产后妇女这些因素的健康促进干预措施是否会减轻抑郁症状。这项研究采用随机对照设计，考察了通过营养助理的家访和激励性电话咨询来促进健康生活方式的教育干预措施 Just for You (JFY) 计划对产后抑郁症状的影响。共有 679 名符合特殊补充营养计划妇女、婴儿和儿童 (WIC) 资格的妇女在分娩后 6-20 周招募，并随机分为常规 WIC 护理或 JFY。使用意向治疗分析，作者在平均婴儿年龄为 15 个月时对完成随访的 403 名女性（59%）进行了基于中心流行病学研究抑郁量表 (CES-D) 的抑郁症状建模，调整了基线 CES-D、年龄、家庭收入和随机分层（体重指数 (BMI)，种族/地区）。作为二次分析，作者评估了与社会支持和改变一个或多个干预目标健康行为的自我效能相关的潜在中介因素。与接受常规 WIC 护理的女性相比，随机分配到 JFY 的女性报告的 CES-D 评分低 2.5 分（P = 0.046）。这种关系被自我效能的变化减弱（β = -2.3；P = 0.065），表明该结构可能部分介导了 JFY 对产妇抑郁症状的影响。通过家访和电话提供的健康促进干预可以在产后 15 个月降低低收入、种族多样化女性的抑郁症状。
