scholarly journals Implemented New Technologies within the Complexity of Medical Rehabilitations: Improvement of Mental Health and Synergetic Outcomes with Healthcare Service Effects

2021 ◽  
Author(s):  
Franziska Maria Keller ◽  
Alina Dahmen ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Sonia Lippke
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Healthcare Service ◽  
New Technologies ◽  
Intervention Group ◽  
Healthcare Services ◽  
Rehabilitation Program ◽  
Face To Face ◽  
Psychosomatic Rehabilitation ◽  
Digital Interventions

The need for new technologies into healthcare services has been stressed. However, little is known about the effectiveness of digital interventions integrated in psychosomatic rehabilitation processes. Data from 724 patients from psychosomatic rehabilitation clinics were analyzed for effectiveness of digital trainings examined by a change in symptoms related to depression, anxiety, stress and loneliness from pre- to post-rehabilitation. Rehabilitation satisfaction was examined in association with reaching rehabilitation goals and satisfaction with communication. Mixed repeated measures analysis of covariances, analysis of covariances, and hierarchical stepwise regression analyses were performed. Results indicated a superior effectiveness for the intervention group receiving all offered digital treatments in addition to the regular face-to-face rehabilitation program with regard to symptoms of depression, F(2,674)=3.93, p<.05, ηp2=.01), and anxiety, F(2,678)=3.68, p<.05, ηp2=.01), post-rehabilitation with large effect sizes for both depression (d=1.28) and anxiety (d=1.08). In addition, rehabilitation satisfaction was positively associated with reaching rehabilitation goals and perceived communication with healthcare workers. Digital interventions appeared effective in supporting mental health of psychosomatic rehabilitation patients post-rehabilitation. This finding supports the inclusion of multidisciplinary and interdisciplinary digital and face-to-face treatment programs and call for more implementations of new technologies in a context of complexity to improve health and healthcare service.

scholarly journals Implementing Digital Trainings within Medical Rehabilitations: Improvement of Mental Health and Synergetic Outcomes with Healthcare Service

2021 ◽  
Vol 18 (17) ◽  
pp. 8936
Author(s):  
Franziska Maria Keller ◽  
Alina Dahmen ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Sonia Lippke
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Healthcare Service ◽  
New Technologies ◽  
Intervention Group ◽  
Healthcare Services ◽  
Rehabilitation Program ◽  
Face To Face ◽  
Psychosomatic Rehabilitation ◽  
Digital Interventions

The need for new technologies in healthcare services has been stressed. However, little is known about the effectiveness of digital interventions integrated in psychosomatic rehabilitation processes. Data from 724 patients from psychosomatic rehabilitation clinics were analyzed with regard to the effectiveness of digital trainings indicated by a change in symptoms related to depression, anxiety, stress, and loneliness from pre– to post–rehabilitation. Rehabilitation satisfaction was examined in association with reaching rehabilitation goals and satisfaction with communication. A mixed repeated measures analyses of covariance, analyses of covariance, and hierarchical stepwise regression analyses were performed. Results indicated a superior effectiveness for the intervention group receiving all offered digital treatments in addition to the regular face-to-face rehabilitation program with regard to symptoms of depression (F (2674) = 3.93, p < 0.05, ηp2 = 0.01), anxiety (F (2678) = 3.68, p < 0.05, ηp2 = 0.01) post-rehabilitation, with large effect sizes for both depression (d = 1.28) and anxiety (d = 1.08). In addition, rehabilitation satisfaction was positively associated with reaching rehabilitation goals and perceived communication with healthcare workers. Digital interventions appeared effective in supporting mental health of psychosomatic rehabilitation patients’ post-rehabilitation. These findings support the inclusion of multidisciplinary and interdisciplinary digital and face-to-face treatment programs and call for more implementations of new technologies in a context of complexity to improve health and healthcare service.

Toward establishing telepsychology guideline: Turning the challenges of COVID-19 into opportunity (Preprint)

2020 ◽  
Author(s):  
Mohammed M. J. Alqahtani
Keyword(s):  
Mental Health ◽  
Health Care Services ◽  
Task Force ◽  
Healthcare Services ◽  
Psychological Services ◽  
Face To Face ◽  
Care Services ◽  
Governance Model ◽  
Provision Of Services ◽  
Temporary Response

BACKGROUND The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. OBJECTIVE This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHODS A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSIONS Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

Gender Differences in Youth Suicide and Healthcare Service Use

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Helen-Maria Vasiliadis
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Outpatient Services ◽  
Health Related ◽  
Healthcare Service Use ◽  
Ed Visits

Abstract. Background: Healthcare service use among suicide decedents must be well characterized and understood since a key strategy for preventing suicide is to improve healthcare providers' ability to effectively detect and treat those in need. Aims: To determine gender differences in healthcare service use 12 months prior to suicide. Method: Data for 1,231 young Quebec residents (≤ 25 years) who died by suicide between 2000 and 2007 were collected from public health insurance agency databases and coroner registers. Healthcare visits were categorized according to the setting (emergency department [ED], outpatient, and hospital) and their nature (mental health vs. non-mental health). Results: Girls were more likely than boys (82.5% vs. 74.9%, p = .011) to have used healthcare services in the year prior to death. A higher proportion of girls had used outpatient services (79.0% vs. 69.5%, p = .003), had been hospitalized (25.7% vs. 15.6%, p < .001) and had received a mental health-related diagnosis (46.7% vs. 33.1%, p < .001). However, no gender differences were observed in ED visits (59.5% vs. 54.5%, p = .150). Conclusion: There is an important proportion of suicide decedents who did not receive a mental health diagnosis and healthcare services in the year prior to death. Future studies should focus on examining gender-specific individual and health system barriers among suicide decedents as well as the quality of care offered regarding detection and treatment.

scholarly journals Trial for the Prevention of Depression (TriPoD) in final-year secondary students: Study protocol for a cluster randomised controlled trial

2020 ◽  
Author(s):  
Y Perry ◽  
AL Calear ◽  
A Mackinnon ◽  
PJ Batterham ◽  
J Licinio ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Intervention Group ◽  
School Level ◽  
Response To Treatment ◽  
School Students ◽  
Cluster Randomised ◽  
The Impact

© 2015 Perry et al. Background: Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations. Methods/Design: Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools. Discussion: This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606. Registered 25 March 2014.

scholarly journals A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial

10.2196/14269 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e14269 ◽  
Author(s):  
Cássia Canha Coelhoso ◽  
Patricia Renovato Tobo ◽  
Shirley Silva Lacerda ◽  
Alex Heitor Lima ◽  
Carla Regina Camara Barrichello ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Intervention Group ◽  
Working Women ◽  
Well Being ◽  
Mobile App ◽  
World Health ◽  
Control Group ◽  
Work Related

Background Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. Objective This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. Methods Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. Results Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). Conclusions The well-being mobile app was effective in reducing employee stress and improving well-being. Trial Registration Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

scholarly journals An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial

10.2196/26814 ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. e26814
Author(s):  
J Carola Pérez ◽  
Olga Fernández ◽  
Cristián Cáceres ◽  
Álvaro E Carrasco ◽  
Markus Moessner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Online Platform ◽  
Face To Face ◽  
Eq Vas

Background Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear. Objective The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression. Methods A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467

scholarly journals The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review (Preprint)

2019 ◽  
Author(s):  
Hailey Tremain ◽  
Carla McEnery ◽  
Kathryn Fletcher ◽  
Greg Murray
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Narrative Review ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Face To Face ◽  
Digital Interventions ◽  
Mental Health Interventions ◽  
Serious Mental Illnesses

BACKGROUND Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. OBJECTIVE This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. METHODS A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. RESULTS Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. CONCLUSIONS More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

scholarly journals A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Cássia Canha Coelhoso ◽  
Patricia Renovato Tobo ◽  
Shirley Silva Lacerda ◽  
Alex Heitor Lima ◽  
Carla Regina Camara Barrichello ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Intervention Group ◽  
Working Women ◽  
Well Being ◽  
Mobile App ◽  
World Health ◽  
Control Group ◽  
Work Related

BACKGROUND Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (<italic>t</italic><sub>1</sub>), midintervention (<italic>t</italic><sub>4</sub>=4 weeks after <italic>t</italic><sub>1</sub>) and postintervention (<italic>t</italic><sub>8</sub>=8 weeks after <italic>t</italic><sub>1</sub>). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete <italic>t</italic><sub>4</sub> and <italic>t</italic><sub>8</sub> assessments were equally distributed between groups (<italic>t</italic><sub>4</sub>: control group=34.6% [83/240] and intervention group=40.8% [102/250]; <italic>P</italic>=.16; <italic>t</italic><sub>8</sub>: control group=29.9% [47/157] and intervention group=21.6% [32/148]; <italic>P</italic>=.10). Both groups showed a significant increase in general well-being as a function of time (<italic>F</italic><sub>2,426</sub>=5.27; <italic>P</italic>=.006), but only the intervention group presented a significant increase in work-related well-being (<italic>F</italic><sub>2,426</sub>=8.92; <italic>P</italic>&lt;.001), as well as a significant reduction in work-related and overall stress (<italic>F</italic><sub>2,426</sub>=5.50; <italic>P</italic>=.004 and <italic>F</italic><sub>2,426</sub>=8.59; <italic>P</italic>&lt;.001, respectively). CONCLUSIONS The well-being mobile app was effective in reducing employee stress and improving well-being. CLINICALTRIAL Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

scholarly journals Trial for the Prevention of Depression (TriPoD) in final-year secondary students: Study protocol for a cluster randomised controlled trial

2020 ◽  
Author(s):  
Y Perry ◽  
AL Calear ◽  
A Mackinnon ◽  
PJ Batterham ◽  
J Licinio ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Intervention Group ◽  
School Level ◽  
Response To Treatment ◽  
School Students ◽  
Cluster Randomised ◽  
The Impact

© 2015 Perry et al. Background: Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations. Methods/Design: Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools. Discussion: This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606. Registered 25 March 2014.

scholarly journals Improving perinatal mental health : a pilot study of the Online Mothers and Babies course with couples

2021 ◽  
Author(s):  
◽  
Shannon Marie Canfield
Keyword(s):  
Mental Health ◽  
Pregnant Woman ◽  
Pilot Study ◽  
Repeated Measures ◽  
Research Question ◽  
Intervention Group ◽  
Higher Order ◽  
Perinatal Mental Health ◽  
Cultural Tensions ◽  
Anxiety Depression

Untreated perinatal mood and anxiety disorders (PMADs) have short- and long-term consequences for mental, physical, developmental, social, and economic outcomes affecting the mother, infant, family, and community. Online health interventions effectively treat mental health disorders and increase access to care for people at risk of experiencing PMADs. Successful interventions utilize cognitive behavioral therapy to deliver psycho-educational materials, targeting women at various perinatal times, and suggest the content applicable for key support people (i.e., partner, family, friends). Perception of social support is known to be protective for PMADs, and partners are a primary source. However, less is known about engaging the couple in preventative programming, and few studies have included or recruited partners. This pilot study is one of the first to engage couples (N = 31) in a sequential, mixed-methods research project using randomized control trial to test the efficacy of an existing Online Mothers and Babies Course (eMB) for reducing symptoms of anxiety, depression, or perception of stress and adds a new population of participants in the programming-the couple. Participants were cluster-randomized as treatment with eMB or control. Validated instruments were used to measure anxiety, depression, and stress outcomes three times over eight weeks. An intent-to-treat analytic strategy using a factorial ANOVA with repeated measures on group and couple roles (i.e., pregnant woman or partner) and SPSS was used to test the study hypotheses. Post-hoc comparisons were conducted when higher-order interactions were significant. An inductive, thematic analysis was used to analyze qualitative data from post-study intervention group interviews (n = 15). Data were coded with Dedoose analytic software; primary and secondary themes were identified and defined in response to the study research question. Data from surveys and interviews were used to explore participant satisfaction and feelings about partner support while using eMB. There were significant higher-order interactions for all hypotheses. Pairwise comparisons revealed significant role differences for anxiety and depression at various study times, with partners scoring lower than pregnant women on average. Similarly, there were significant differences between women across groups for anxiety and perception of stress in favor of the intervention. In general, participants found the eMB satisfactory and suggested thoughtful inclusion of partner-related materials. Regarding feelings about partner supportiveness, participants described eMB as promoting PMAD awareness for both members of the couple and described engaging in or becoming aware of socio-cultural tensions including "end goal" thoughts and behaviors, partners putting off their mental health needs in efforts to be supportive of the pregnant woman, and women describing feeling like "a vessel". In sum, eMB participants were satisfied with the course content, yet there was a clear desire for material applicable and relatable to all end users indicating the need for modifications in future studies. Inclusion of partners in accessible interventions may increase perceived support within couples through increased awareness of perinatal mental health experiences and needs. Addressing socio-cultural tensions through education, policy, and practice changes more supportive of perinatal mental health are needed.

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