scholarly journals A Smartphone-Assisted Brief Behavioral Intervention for Pregnant Women with Depression: a Study Protocol of a Randomized Controlled Trial

2020 ◽  
Author(s):  
Pedro Zuccolo ◽  
Mariana O. Xavier ◽  
Alicia Matijasevich ◽  
Guilherme Polanczyk ◽  
Daniel Fatori
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Support ◽  
Pregnant Women ◽  
Maternal Depression ◽  
Active Control ◽  
Well Being ◽  
Smartphone Applications ◽  
Educational Content ◽  
Randomized Controlled

Background: Pregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) countries such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression. Methods: We will conduct a 2-arm parallel randomized controlled clinical trial in which 70 pregnant women aged between 16-40 years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8 weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4-5), posttreatment (T2, week 8), and follow-up (T3, when the child is two months-old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8 weeks). Discussion: The potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care.

scholarly journals A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pedro Fonseca Zuccolo ◽  
Mariana O. Xavier ◽  
Alicia Matijasevich ◽  
Guilherme Polanczyk ◽  
Daniel Fatori
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Support ◽  
Pregnant Women ◽  
Maternal Depression ◽  
Active Control ◽  
Well Being ◽  
Smartphone Applications ◽  
Educational Content ◽  
Randomized Controlled

Abstract Background Pregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression. Methods We will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40 years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8 weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4–5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8 weeks). Discussion The potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care. Trial registration ClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.

scholarly journals A Smartphone-Assisted Brief Behavioral Intervention for Pregnant Women with Depression: a Study Protocol of a Randomized Controlled Trial

2021 ◽  
Author(s):  
Pedro Fonseca Zuccolo ◽  
Mariana O. Xavier ◽  
Alicia Matijasevich ◽  
Guilherme Vanoni Polanczyk ◽  
Daniel Fatori
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Support ◽  
Pregnant Women ◽  
Active Control ◽  
Behavioral Intervention ◽  
Maternal Mental Health ◽  
Smartphone Applications ◽  
Randomized Controlled ◽  
Brief Behavioral Intervention

Abstract Background: Pregnancy is strongly associated with increased risk for depression, but treating pregnant women is challenging. The use of psychiatric medications might result in developmental problems in the child, therefore must be used with caution. Psychosocial interventions require specialized professionals which are scarce, especially in low- and middle-income countries. In this context, smartphone-based interventions show immense potential. We created Motherly, a smartphone app designed to promote maternal mental health. The Motherly app delivers a package of interventions, including mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and psychoeducational content. With this study, we will test the effectiveness of the Motherly app in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression. Methods: We will conduct a 2-arm parallel randomized controlled clinical trial in which 70 pregnant women between 16-40 years with depression will be randomized to intervention or active control. The intervention group will have access to the Motherly app. The active control group will have access to a simplified version of the app consisting exclusively of psychoeducational content. Both groups will undergo four sessions of CBT in 8 weeks. Participants will be evaluated by assessors blind to randomization and allocation status at baseline (T0), midpoint (T1, week 4-5), posttreatment (T2, week 8), and follow-up (T3, when the child is two months-old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8 weeks). Discussion: There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can treat depression, a condition for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression have the potential to circumvent barriers that prevent pregnant women from accessing mental health care.Trial Registration: A Smartphone-Assisted Brief Behavioral Intervention for Pregnant Women With Depression (clinicaltrials.gov, registry number: NCT04495166, prospectively registered in 29/07/2020).

scholarly journals The ‘new normal’ includes online prenatal exercise: Exploring pregnant women’s experiences during the pandemic and the role of virtual group fitness on maternal mental health

2021 ◽  
Author(s):  
Cristina Silva-Jose ◽  
Taniya S Nagpal ◽  
Javier Coterón ◽  
Ruben Barakat ◽  
Michelle F Mottola
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Exercise Program ◽  
Well Being ◽  
Group Exercise ◽  
Exercise Classes ◽  
Prenatal Exercise ◽  
Online Group

Abstract Background: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic. Furthermore, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs.Methods: Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women’s experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory (STAI) and these data supplemented qualitative findings. Results: Twenty-four women were interviewed, and the average STAI score was 32.23 ± 9.31, ranging from low to moderate anxiety. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional.Conclusion: Pregnant women are receptive to online group exercise classes and expressed that these are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.

Risk of Psychological Distress Among Community-Dwelling Older Adults Experiencing Spousal Loss in Ghana

2019 ◽  
Vol 60 (3) ◽  
pp. 416-427 ◽  
Author(s):  
Razak M Gyasi ◽  
David R Phillips
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Psychological Distress ◽  
Older Persons ◽  
Well Being ◽  
Community Dwelling ◽  
Full Sample ◽  
Spousal Loss

Abstract Background Spousal loss, common in older age, has been linked to negative mental health outcomes and well-being, yet the mechanisms linking spousal loss and mental health are still unclear. Objective To investigate whether physical activity, social support, and gender modify the psychological distress effects of marital loss among community-dwelling older persons in Ghana. Methods Data from a 2016/2017 Ageing, Health, Psychological Well-being, and Health-seeking Behavior Study (N = 1,200) were examined. OLS regression models examined associations between spousal loss and psychological distress outcomes and interaction terms. Results Spousal loss (widowhood and divorce/separation) was associated with psychological distress (measured by the Kessler Psychological Distress Scale [KPDS-10]) for the full sample (β = .798, p < .001), women (β = .831, p < .001) and for men (β = .533, p < .05). After adjusting for potential confounders, the associations between spousal loss and psychological distress persisted for the full sample (β = .727, p < .001) and females only (β = .730, p < .001). In particular, when experiencing spousal loss, those with meaningful social support (β = −.856, p < .005) and engaged in physical activity (β = −.258, p < .001) were less likely to be psychologically distressed. Conclusions Spousal loss precipitates an independent risk of psychological distress in older age particularly among women, but social support and physical activity engagements moderate the relationship. These findings support the premise that providing opportunities to improve social support and regular physical activity may buffer the effects of psychological distress among older persons experiencing spousal loss. Providing support for older adults in times of divorce and widowhood, and working towards changes in social attitudes towards divorce are important considerations.

scholarly journals Rationale and design of ePPOP-ID: a multicenter randomized controlled trial using an electronic-personalized program for obesity in pregnancy to improve delivery

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Philippe Deruelle ◽  
Sophie Lelorain ◽  
Sylvie Deghilage ◽  
Emmanuelle Couturier ◽  
Elodie Guilbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Pregnant Women ◽  
Eating Behavior ◽  
Controlled Trial ◽  
Well Being ◽  
Randomized Controlled ◽  
Link Type ◽  
Multicenter Randomized Controlled Trial ◽  
In Pregnancy

Abstract Background Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for adverse pregnancy, delivery and birth outcomes. Pregnancy is an ideal moment for nutritional interventions in order to establish healthier lifestyle behaviors in women at high risk of obstetric and neonatal complications. Methods Electronic-Personalized Program for Obesity during Pregnancy to Improve Delivery (ePPOP-ID) is an open multicenter randomized controlled trial which will assess the efficacy of an e-health web-based platform offering a personalized lifestyle program to obese pregnant women in order to reduce the rate of labor procedures and delivery interventions in comparison to standard care. A total of 860 eligible pregnant women will be recruited in 18 centers in France between 12 and 22 weeks of gestation, randomized into the intervention or the control arm and followed until 10 weeks of postpartum. The intervention is based on nutrition, eating behavior, physical activity, motivation and well-being advices in which personalization is central, as well as the use of a mobile/tablet application. Inputs includes data from the medical record of participants (medical history, anthropometric data), from the web platform (questionnaires on dietary habits, eating behavior, physical activity and motivation in both groups), and adherence to the program (time of connection for the intervention group only). Data are collected at inclusion, 32 weeks, delivery and 10 weeks postpartum. As primary outcome, we will use a composite endpoint score of obstetrical interventions during labor and delivery, defined as caesarean section and instrumental delivery (forceps and vacuum extractor). Secondary outcomes will consist of data routinely collected as part of usual antenatal and perinatal care, such as GWG, hypertension, preeclampsia, as well as fetal and neonatal outcomes including premature birth, gestational age at birth, birth weight, macrosomia, Apgar score, arterial umbilical cord pH, neonatal traumatism, hyperbilirubinemia, respiratory distress syndrome, transfer in neonatal intensive care unit, and neonatal adiposity. Post-natal outcomes will be duration of breastfeeding, maternal weight retention and child weight at postnatal visit. Discussion The findings of the ePPOP-ID trial will help design e-health intervention program for obese women in pregnancy. Trial registration ClinicalTrials.gov Identifier: NCT02924636 / October 5th 2016.

scholarly journals An Integrated Approach to Improve Maternal Mental Health and Well-Being During the COVID-19 Crisis

2020 ◽  
Vol 11 ◽  
Author(s):  
Rahul Shidhaye ◽  
Purnima Madhivanan ◽  
Pallavi Shidhaye ◽  
Karl Krupp
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Integrated Approach ◽  
Well Being ◽  
Mitigation Strategies ◽  
Increased Risk ◽  
The Impact ◽  
Health And Well Being

The ongoing COVID-19 pandemic has led to disruption of normal life across the globe, severely affecting the already vulnerable populations such as the pregnant women. Maternal mental health and well-being is a public health priority and the evidence about the impact of COVID-19 on mental health status of pregnant women is gradually emerging. The findings of the recently published studies suggest that increased risk perception about contracting COVID-19, reduced social support, increase in domestic violence, disruption of antenatal care, and economic consequences of COVID-19 mitigation strategies can lead to adverse mental health outcomes in antenatal period. There is a significant increase in antenatal depression and anxiety since the onset of COVID-19 and social determinants of health (e.g., younger age, lower education, lower income) are associated with these poor outcomes. In this paper, we propose an integrated approach to improve the mental health and well-being of pregnant women. Physical activity and/or mind-body interventions like yoga can be practiced as self-care interventions by pregnant women. Despite social distancing being the current norm, efforts should be made to strengthen social support. Evidence-based interventions for perinatal depression should be integrated within the health system and stepped, collaborative care using non-specialist health workers as key human resource be utilized to improve access to mental health services. Use of digital platforms and smartphone enabled delivery of services has huge potential to further improve the access to care. Most importantly, the COVID-19 related policy guidelines should categorically include maternal mental health and well-being as a priority area.

scholarly journals Performers of the night: Examining the mental health of electronic music artists

2021 ◽  
pp. 030573562097698
Author(s):  
Jolan Kegelaers ◽  
Lewie Jessen ◽  
Eline Van Audenaerde ◽  
Raôul RD Oudejans
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Sleep Disturbance ◽  
Electronic Music ◽  
Music Performance ◽  
Well Being ◽  
Cross Sectional ◽  
Music Performance Anxiety ◽  
Symptoms Of Depression ◽  
Levels Of Functioning

Despite growing popular interest for the mental health of electronic music artists, scientific research addressing this topic has remained largely absent. As such, the aim of the current study was to examine the mental health of electronic music artists, as well as a number of determinants. Using a cross-sectional quantitative design, a total of 163 electronic music artists participated in this study. In line with the two-continua model of mental health, both symptoms of depression/anxiety and well-being were adopted as indicators for mental health. Furthermore, standardized measures were used to assess potential determinants of mental health, including sleep disturbance, music performance anxiety, alcohol abuse, drug abuse, occupational stress, resilience, and social support. Results highlighted that around 30% of participants experienced symptoms of depression/anxiety. Nevertheless, the majority of these participants still demonstrated at least moderate levels of functioning and well-being. Sleep disturbance formed a significant predictor for both symptoms of depression/anxiety and well-being. Furthermore, resilience and social support were significant predictors for well-being. The results provide a first glimpse into the mental health challenges experienced by electronic music artists and support the need for increased research as well as applied initiatives directed at safeguarding their mental health.

scholarly journals Physical activity and mental well-being under COVID-19 lockdown: a cross-sectional multination study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Costas I. Karageorghis ◽  
Jonathan M. Bird ◽  
Jasmin C. Hutchinson ◽  
Mark Hamer ◽  
Yvonne N. Delevoye-Turrell ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Young Adults ◽  
Sedentary Behavior ◽  
Online Survey ◽  
Electronic Device ◽  
Well Being ◽  
Middle Aged ◽  
Steps Per Day ◽  
Western Nations

Abstract Background COVID-19 lockdowns have reduced opportunities for physical activity (PA) and encouraged more sedentary lifestyles. A concomitant of sedentariness is compromised mental health. We investigated the effects of COVID-19 lockdown on PA, sedentary behavior, and mental health across four Western nations (USA, UK, France, and Australia). Methods An online survey was administered in the second quarter of 2020 (N = 2541). We measured planned and unplanned dimensions of PA using the Brunel Lifestyle Physical Activity Questionnaire and mental health using the 12-item General Health Questionnaire. Steps per day were recorded only from participants who used an electronic device for this purpose, and sedentary behavior was reported in hours per day (sitting and screen time). Results In the USA and Australia samples, there was a significant decline in planned PA from pre- to during lockdown. Among young adults, Australians exhibited the lowest planned PA scores, while in middle-aged groups, the UK recorded the highest. Young adults exhibited the largest reduction in unplanned PA. Across nations, there was a reduction of ~ 2000 steps per day. Large increases in sedentary behavior emerged during lockdown, which were most acute in young adults. Lockdown was associated with a decline in mental health that was more pronounced in women. Conclusions The findings illustrate the deleterious effects of lockdown on PA, sedentary behavior, and mental health across four Western nations. Australian young and lower middle-aged adults appeared to fare particularly badly in terms of planned PA. The reduction in steps per day is equivalent to the non-expenditure of ~ 100 kcal. Declines in mental health show how harmful lockdowns can be for women in particular.

scholarly journals Military spouses with deployed partners are at greater risk of poor perinatal mental health: a scoping review

2019 ◽  
Vol 165 (5) ◽  
pp. 363-370 ◽  
Author(s):  
Lauren Rose Godier-McBard ◽  
L Ibbitson ◽  
C Hooks ◽  
M Fossey
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Well Being ◽  
Perinatal Period ◽  
Poor Mental Health ◽  
Adverse Outcomes ◽  
Military Spouses ◽  
Perinatal Mental Health

BackgroundPoor mental health in the perinatal period is associated with a number of adverse outcomes for the individual and the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems.MethodsA scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O’Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE.ResultsThirteen papers fulfilled the inclusion criteria, all from the USA, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support.ConclusionsUS literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.

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