The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial

BackgroundPostpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the use of web-based intervention programs. O...

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Main Authors: Carlos Carona, Marco Pereira, Anabela Araújo-Pedrosa, Maria Cristina Canavarro, Ana Fonseca
Format: Article
Language:English
Published: JMIR Publications 2023-03-01
Series:JMIR Mental Health
Online Access:https://mental.jmir.org/2023/1/e39253
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author Carlos Carona
Marco Pereira
Anabela Araújo-Pedrosa
Maria Cristina Canavarro
Ana Fonseca
author_facet Carlos Carona
Marco Pereira
Anabela Araújo-Pedrosa
Maria Cristina Canavarro
Ana Fonseca
author_sort Carlos Carona
collection DOAJ
description BackgroundPostpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the use of web-based intervention programs. ObjectiveThe objective of this study was 2-fold: first, to assess the efficacy of Be a Mom, a brief web-based selective or indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (ie, emotion regulation, self-compassion, and psychological flexibility) to improved perinatal mental health outcomes. MethodsThis 2-arm, open-label randomized controlled trial involved a sample of 1053 perinatal women presenting high risk for PPD who were allocated to the Be a Mom intervention group or a waitlist control group and completed self-report measures at baseline and postintervention assessments. Univariate latent change score models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup-model approach to detect differences between the intervention and control groups and a 2-wave latent change score model to examine whether changes in processes were related to changes in outcomes. ResultsBe a Mom was found to be effective in reducing depressive (intervention group: µΔ=–3.35; P<.001 vs control group: µΔ=–1.48; P<.001) and anxiety symptoms (intervention group: µΔ=–2.24; P<.001 vs control group: µΔ=–0.43; P=.04) in comparison with the control group, where such changes were inexistent or much smaller. All 3 psychological processes under study improved statistically significantly in posttreatment assessments: emotion regulation ability (Δχ23=12.3; P=.007) and psychological flexibility (Δχ23=34.9; P<.001) improved only in the intervention group, and although self-compassion increased in both groups (Δχ23=65.6; P<.001), these improvements were considerably greater in the intervention group. ConclusionsThese results suggest that Be a Mom, a low-intensity cognitive behavioral therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms. Trial RegistrationClinicalTrials.gov NCT03024645; https://clinicaltrials.gov/ct2/show/NCT03024645
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spelling doaj.art-c47995093a04441ea68a71c11e7c58cc2023-08-28T23:47:01ZengJMIR PublicationsJMIR Mental Health2368-79592023-03-0110e3925310.2196/39253The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled TrialCarlos Caronahttps://orcid.org/0000-0002-3605-3513Marco Pereirahttps://orcid.org/0000-0002-6086-2329Anabela Araújo-Pedrosahttps://orcid.org/0000-0002-1141-6015Maria Cristina Canavarrohttps://orcid.org/0000-0002-5083-7322Ana Fonsecahttps://orcid.org/0000-0003-1395-1406 BackgroundPostpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the use of web-based intervention programs. ObjectiveThe objective of this study was 2-fold: first, to assess the efficacy of Be a Mom, a brief web-based selective or indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (ie, emotion regulation, self-compassion, and psychological flexibility) to improved perinatal mental health outcomes. MethodsThis 2-arm, open-label randomized controlled trial involved a sample of 1053 perinatal women presenting high risk for PPD who were allocated to the Be a Mom intervention group or a waitlist control group and completed self-report measures at baseline and postintervention assessments. Univariate latent change score models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup-model approach to detect differences between the intervention and control groups and a 2-wave latent change score model to examine whether changes in processes were related to changes in outcomes. ResultsBe a Mom was found to be effective in reducing depressive (intervention group: µΔ=–3.35; P<.001 vs control group: µΔ=–1.48; P<.001) and anxiety symptoms (intervention group: µΔ=–2.24; P<.001 vs control group: µΔ=–0.43; P=.04) in comparison with the control group, where such changes were inexistent or much smaller. All 3 psychological processes under study improved statistically significantly in posttreatment assessments: emotion regulation ability (Δχ23=12.3; P=.007) and psychological flexibility (Δχ23=34.9; P<.001) improved only in the intervention group, and although self-compassion increased in both groups (Δχ23=65.6; P<.001), these improvements were considerably greater in the intervention group. ConclusionsThese results suggest that Be a Mom, a low-intensity cognitive behavioral therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms. Trial RegistrationClinicalTrials.gov NCT03024645; https://clinicaltrials.gov/ct2/show/NCT03024645https://mental.jmir.org/2023/1/e39253
spellingShingle Carlos Carona
Marco Pereira
Anabela Araújo-Pedrosa
Maria Cristina Canavarro
Ana Fonseca
The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
JMIR Mental Health
title The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
title_full The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
title_fullStr The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
title_full_unstemmed The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
title_short The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial
title_sort efficacy of be a mom a web based intervention to prevent postpartum depression examining mechanisms of change in a randomized controlled trial
url https://mental.jmir.org/2023/1/e39253
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