针对说西班牙语和英语的孕妇的产后抑郁在线预防：一项随机对照试验试点研究
Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial.
作者信息
Barrera Alinne Z, Wickham Robert E, Muñoz Ricardo F
机构信息
Palo Alto University, Palo Alto, California, USA ; Institute for International Internet Interventions for Health (i4Health), Palo Alto, California, USA.
Palo Alto University, Palo Alto, California, USA.
出版信息
Internet Interv. 2015 Sep 1;2(3):257-265. doi: 10.1016/j.invent.2015.06.002.
BACKGROUND
Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/ a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD.
METHODS
Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses.
RESULTS
Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction ( = -0.514, χ (1) = 3.43, = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms ( = -0.605, χ (1) = 5.20, =.023).
CONCLUSIONS
This study provides preliminary evidence that Internet interventions are a promising method toward expanding the reach of psychological resources to perinatal women at-risk for PPD.
背景
产后抑郁症（PPD）是一个影响全球各地女性的孕产妇心理健康问题。不幸的是，即使在发达国家，仍有一半的病例未被发现，因此未得到治疗。低收入和中等收入国家的人群往往未充分利用心理健康服务，部分原因是可用的心理资源数量有限。这项试点随机对照试验的主要目的是将母婴课程/PPD预防干预措施调整为互联网模式，描述参与干预网站的孕妇特征，并获取关于互联网干预降低PPD风险疗效的初步数据。
方法
招募了18岁及以上有兴趣自行使用该网站的孕妇，并将她们随机分配到全自动自助式互联网干预组或仅提供信息的对照组。随机参与者被邀请在产后六个月内每月完成抑郁评估。为了检验互联网干预的预防效果，纳入研究分析的孕妇需未达到当前重度抑郁发作的标准、参与了研究网站且在产后随访期间提供了抑郁数据。
结果
参与者为111名主要讲西班牙语（82.9%）且为拉丁裔/西班牙裔（71.3%）的孕妇，她们居住在全球23个国家。预防干预条件的效果在预先设定的α水平上未达到显著。然而，观察到的系数朝着假设的方向发展（= -0.514，χ(1)= 3.43，= 0.061；HR = 0.598）。对于报告产前抑郁症状水平高（与低相比）的孕妇，接受电子母婴互联网干预的益处更大（= -0.605，χ(1)= 5.20，= 0.023）。
结论
本研究提供了初步证据，表明互联网干预是一种有前景的方法，可将心理资源扩展到有PPD风险的围产期女性。
Zotero 插件