scholarly journals Acceptability and Appropriateness of a Perinatal Depression Preventive Group Intervention: A Qualitative Analysis

2019 ◽  
Author(s):  
Alicia Diebold ◽  
Melissa Segovia ◽  
Jessica K. Johnson ◽  
Aria Degillio ◽  
Dana Zakieh ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Group Intervention ◽  
Home Visiting ◽  
Perinatal Depression ◽  
Controlled Trial ◽  
Health Concern ◽  
Preventive Interventions

Abstract Background Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A current cluster-randomized controlled trial is examining the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs. Methods The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored. Results Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms. Conclusions Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals.

scholarly journals Acceptability and Appropriateness of a Perinatal Depression Preventive Group Intervention: A Qualitative Analysis

2020 ◽  
Author(s):  
Alicia Diebold ◽  
Melissa Segovia ◽  
Jessica K. Johnson ◽  
Aria Degillio ◽  
Dana Zakieh ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Group Intervention ◽  
Home Visiting ◽  
Perinatal Depression ◽  
The United States ◽  
Health Concern ◽  
Preventive Interventions

Abstract Background: Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A current cluster-randomized controlled trial is examining the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs. Methods: The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention to women in one of seven states in the United States. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored. Results: Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms. Conclusions: Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals. Trial Registration: This trial is registered on ClinicalTrials.gov (Initial post: December 1, 2016; identifier: NCT02979444; https://clinicaltrials.gov/ct2/show/NCT02979444).

scholarly journals Acceptability and Appropriateness of a Perinatal Depression Preventive Group Intervention: A Qualitative Analysis

2020 ◽  
Author(s):  
Alicia Diebold ◽  
Melissa Segovia ◽  
Jessica K. Johnson ◽  
Aria Degillio ◽  
Dana Zakieh ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Group Intervention ◽  
Home Visiting ◽  
Perinatal Depression ◽  
The United States ◽  
Health Concern ◽  
Preventive Interventions

Abstract Background: Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A cluster-randomized controlled trial examined the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs.Methods: The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention to women in one of seven states in the United States. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored.Results: Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms. Conclusions: Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals. Trial Registration: This trial is registered on ClinicalTrials.gov (Initial post: December 1, 2016; identifier: NCT02979444; https://clinicaltrials.gov/ct2/show/NCT02979444).

scholarly journals Acceptability and Appropriateness of a Perinatal Depression Preventive Group Intervention: A Qualitative Analysis

2019 ◽  
Author(s):  
Alicia Diebold ◽  
Melissa Segovia ◽  
Jessica K. Johnson ◽  
Aria Degillio ◽  
Dana Zakieh ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Group Intervention ◽  
Home Visiting ◽  
Perinatal Depression ◽  
The United States ◽  
Health Concern ◽  
Preventive Interventions

Abstract Background Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A current cluster-randomized controlled trial is examining the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs. Methods The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention to women in one of seven states in the United States. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored. Results Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms. Conclusions Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals.

scholarly journals Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child’s health

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
M. Bischoff ◽  
V. Howland ◽  
J. Klinger-König ◽  
S. Tomczyk ◽  
S. Schmidt ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Pregnant Women ◽  
Health Professionals ◽  
Mental Stress ◽  
Controlled Trial ◽  
Maternal Sensitivity ◽  
Control Group ◽  
Randomized Controlled ◽  
Ecological Momentary

Abstract Background As early as pregnancy, maternal mental stress impinges on the child’s development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child’s needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity. Methods A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child’s mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals. Discussion The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child’s and mothers’ mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner. Trial registration German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111–1230-9826. Registered 01 April 2019.

Home visit in mental health care: the “italian way”

2011 ◽  
Vol 26 (S2) ◽  
pp. 531-531
Author(s):  
S. Ferrari ◽  
L. Malavolta ◽  
M.R. Laghezzi Ortolani ◽  
S. Mimmi ◽  
M. Rigatelli
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Home Visit ◽  
Home Visiting ◽  
Health Centre ◽  
Home Visits

IntroductionHome visits are an essential component of community mental health care for their potentials in prevention and rehabilitative interventions. In the tradition of the Italian organisation, home visits are commonly carried out by psychiatric nurses, usually case managers for patients receiving them. Poor training and scarce integration to other clinical activities are common problems addressed by mental health professionals.MethodsA written survey on attitudes, beliefs and reality of home visiting was submitted to all 95 mental health professionals working in the community mental health centres of the Modena District, North of Italy. The survey included the following sections: general information (including seniority of service); personal experience and emotions; description of “what actually happens”; opinions on training; comparison between reality and ideals.ResultsNinety-eight percent of contacted professionals responded to the questionnaire. Home visiting should be improved and better integrated according to 55% of respondents. Good integration with social services but poor planning and lack of periodical assessments of effectiveness were emphasized by respondents. Seniority of service was significantly associated to different opinions on aim (p = .043) and numbers of home visits (p = .02) as well as the specific mental health centre was strongly associated to different perceptions on quantitative load of home visits (p < .0001). Almost no perception of danger was addressed by respondents, particularly if older.ConclusionsHome visit is a powerful tool for assertive community treatments in psychiatry and should be a focus for training and research.

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