Problem-solving education to prevent depression among low-income mothers of preterm infants: a randomized controlled pilot trial

• Published in: Archives of women's mental health Vol. 14; no. 4; pp. 317 - 324
• Main Authors: Silverstein, Michael, Feinberg, Emily, Cabral, Howard, Sauder, Sara, Egbert, Lucia, Schainker, Elisabeth, Kamholz, Karen, Hegel, Mark, Beardslee, William
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.08.2011; Springer; Springer Nature B.V
• Subjects: Adult; Clinical trials; Cognitive Therapy - methods; Depression, Mental; Depression, Postpartum - prevention & control; Feasibility Studies; Female; Follow-Up Studies; Humans; Infant, Newborn; Infant, Premature; Infants (Premature); Low income groups; Medicine; Medicine & Public Health; Mothers - education; Mothers - psychology; Obstetric Labor, Premature - psychology; Original Article; Patient Education as Topic - methods; Pilot Projects; Postnatal Care - methods; Postpartum depression; Poverty; Pregnancy; Premature birth; Prevention; Preventive medicine; Problem Solving; Problem-Based Learning - methods; Psychiatry; Psychological aspects; Psychotherapy; Self Concept; Young Adult; Massachusetts; Maternal depression; Preterm birth; Vulnerable populations; Postnatal depression
• ISSN: 1434-1816; 1435-1102
• DOI: 10.1007/s00737-011-0222-6

We sought to assess the feasibility and document key study processes of a problem-solving intervention to prevent depression among low-income mothers of preterm infants. A randomized controlled pilot trial ( n  = 50) of problem-solving education (PSE) was conducted. We assessed intervention provider training and fidelity; recruitment and retention of subjects; intervention acceptability; and investigators' ability to conduct monthly outcome assessments, from which we could obtain empirical estimates of depression symptoms, stress, and functioning over 6 months. Four of four bachelor-level providers were able to deliver PSE appropriately with standardized subjects within 4 weeks of training. Of 12 randomly audited PSE sessions with actual subjects, all met treatment fidelity criteria. Nineteen of 25 PSE subjects (76%) received full four-session courses; no subjects reported negative experiences with PSE. Eighty-eight percent of scheduled follow-up assessments were completed. Forty-four percent of control group mothers experienced an episode of moderately severe depression symptoms over the follow-up period, compared to 24% of PSE mothers. Control mothers experienced an average 1.19 symptomatic episodes over the 6 months of follow-up, compared to 0.52 among PSE mothers. PSE appears feasible and may be a promising strategy to prevent depression among mothers of preterm infants.