William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.
College of Nursing, The Ohio State University, Columbus, Ohio.
Am J Prev Med. 2024 May;66(5):797-808. doi: 10.1016/j.amepre.2024.01.005. Epub 2024 Feb 5.
Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined.
This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content.
SETTING/PARTICIPANTS: Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate.
Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting.
Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors.
There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased.
Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens.
This study is registered with clinicaltrials.gov NCT03416010.
围产期抑郁和焦虑每年给美国卫生系统造成 1.02 亿美元的损失，并导致不良健康后果。研究表明认知行为疗法可以改善这些状况，但获得认知行为疗法的障碍阻碍了其在孕妇中的成功。在这项研究中，研究了基于认知行为疗法的干预对孕妇焦虑、抑郁、压力、健康生活方式信念和行为的影响。
本研究采用了 2 臂 RCT 设计，嵌入在小组产前护理中，其中一个手臂接受基于认知行为疗法的创造个人赋权机会计划，另一个手臂接受健康促进内容。
设置/参与者：2018 年至 2022 年期间在纽约和俄亥俄州接受产前护理的黑人和西班牙裔参与者（n=299），他们在 3 项心理健康措施中的 1 项上筛查得分较高，有资格参加。
参与者随机分为基于认知行为疗法的创造个人赋权机会手册化程序，由妇产科环境中的高级执业护士提供认知行为技能培训活动。
使用有效的和可靠的工具（广泛性焦虑症量表、爱丁堡产后抑郁量表和感知压力量表）测量焦虑、抑郁和压力症状。健康生活方式信念和行为量表检查了保持健康生活方式的信念和报告的健康行为。
两组在焦虑、抑郁、压力、健康信念和行为方面没有统计学上的显著差异。所有测量指标在时间上都有显著改善。从基线到干预结束，焦虑、抑郁和压力显著下降，而健康信念和行为显著增加。
认知行为疗法和嵌入小组产前护理的健康促进内容，由高级执业护士提供，改善了围产期情绪普遍恶化时的心理健康和健康生活方式信念和行为。
这项研究在 clinicaltrials.gov 上注册，编号为 NCT03416010。
