Departments of Pediatrics.
Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine.
Pediatrics. 2023 Mar 1;151(3). doi: 10.1542/peds.2022-058719.
To test effects of a social media-based parenting program for mothers with postpartum depressive symptoms.
We conducted a randomized controlled trial from December 2019 to August 2021 of a parenting program using Facebook. Women with mild-to-moderate depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS] 10-19) were randomized to the program, plus online depression treatment or depression treatment alone for 3 months. Women completed the EPDS monthly and the Parent-Child Early Relational Assessment, Parenting Stress Index-Short Form, and Parenting Sense of Competence pre- and postintervention. Differences among groups were assessed using intention-to-treat analysis.
Seventy-five women enrolled and 66 (88%) completed the study. Participants were predominantly Black (69%), single (57%), with incomes <$55 000 (68%). The parenting group reported a more rapid decline in depressive symptoms than the comparison group (adjusted EPDS difference, -2.9; 95% confidence interval, -4.8 to -1.0 at 1 month). There were no significant group X time interactions for the Parent-Child Early Relational Assessment, Parenting Stress Index-Short Form, or Parenting Sense of Competence scores. Forty-one percent of women sought mental health treatment for worsening symptoms or suicidality. Women in the parenting group who exhibited greater engagement or reported mental health treatment had greater parenting responsiveness.
A social media-based parenting program led to more rapid declines in depressive symptoms but no differences in responsive parenting, parenting stress, or parenting competence relative to a comparison group. Social media can provide parenting support for women with postpartum depressive symptoms, but greater attention to engagement and treatment access are needed to improve parenting outcomes.
检验基于社交媒体的产后抑郁母亲育儿项目的效果。
我们开展了一项 2019 年 12 月至 2021 年 8 月的随机对照试验,研究了一种基于 Facebook 的育儿项目。采用爱丁堡产后抑郁量表(EPDS)(10-19 分)评估,将有轻至中度抑郁症状的母亲随机分为项目组、项目+在线抑郁治疗组或仅抑郁治疗组,疗程均为 3 个月。女性在干预前和干预后 1、2、3、4、5、6 个月完成 EPDS 评分,以及儿童早期关系评估量表、父母压力指数-短式量表和父母教养效能感量表。采用意向治疗分析评估组间差异。
75 名女性入组,66 名(88%)完成研究。参与者主要为黑人(69%)、单身(57%)、收入 <$55000(68%)。与对照组相比,育儿组的抑郁症状改善更快(调整后 EPDS 差值,-2.9;1 个月时,95%置信区间为-4.8 至-1.0)。儿童早期关系评估量表、父母压力指数-短式量表和父母教养效能感量表的组间差异无统计学意义。41%的女性因症状恶化或自杀意念寻求精神科治疗。在育儿组中,表现出更高的参与度或报告有精神健康治疗的女性,其育儿反应能力更高。
基于社交媒体的育儿项目可更迅速地降低抑郁症状,但与对照组相比,对反应性育儿、育儿压力或育儿能力没有影响。社交媒体可以为有产后抑郁症状的女性提供育儿支持,但需要更加关注参与度和治疗机会,以改善育儿结局。