Postnatal Depression Clinical Trial
Official title:
The Effect of a Telephone-based Cognitive-behavioral Intervention on Postnatal Depression: a Randomized Controlled Trial
Purpose: To evaluate the effectiveness of a telephone-based intervention using
cognitive-behavioral approach in preventing postnatal depression and improving quality of
life in first-time Chinese mothers.
Hypothesis: Women who receive the telephone-based cognitive-behavioral intervention will
have a lower level of depressive symptoms (primary outcome) and a higher level of quality of
life at 6 weeks and 6 months postpartum than those who receive the usual postpartum care.
Design and subjects: Randomized controlled trial is used. A sample of postpartum women with
high risk of postnatal depression (EPDS > 9, n = 498) will be randomly assigned to either
the experimental (n = 249) or the control groups (n = 249). The experimental group receives
the intervention and the control group receives usual postpartum care.
Study instruments: EPDS and Medical Outcomes Study Short Form Health Survey (SF-12).
Interventions: The intervention is based on the cognitive-behavioral approach. It consists
of five, 30-minutes sessions delivered weekly from postpartum week one to week five via
telephone.
Main outcome measures and analysis: Outcomes on postnatal depression and quality of life
will be measured by EPDS and SF-12, respectively, at 6 weeks and 6 months postpartum. A
repeated-measures multivariate analysis of variance will be used to compare differences
between two groups.
The aim of this study is to design, implement and evaluate a telephone-based intervention
using cognitive-behavioral approach for first-time mothers during the immediate postpartum
period. The objective is to evaluate the effect of a telephone-based intervention using
cognitive-behavioral approach on postnatal depression and quality of life at 6 weeks and 6
months postpartum.
A longitudinal, randomized, pre and post-test control group design will be used. This design
involves providing a 5-week telephone-based intervention using cognitive-behavioral approach
at the immediate postpartum period (first five weeks postpartum) to women with high risk of
postnatal depression. The experimental group receives the intervention on top of the usual
postpartum care, while the control group receives the usual postpartum care only.
Participants will be recruited through the postnatal wards at three regional public
hospitals in Hong Kong. Eligible participants will be randomly assigned to either the
telephone-based intervention or control group. The allocation schedule will be prepared in
advanced using a restricted randomization scheme (random permutated blocks of six) by a
random number table. The random numbers will be placed in sequentially numbered, opaque and
sealed envelopes. After the women have given informed written consent at 2-3 days postpartum
at the postnatal units, the research assistant will open the envelope containing the group
assignment.
Participants will be postpartum women who meet the inclusion and exclusion criteria. The
research nurse will determine if the women meet the sample inclusion criteria from their
records. Potential eligible participants will be approached on the second or third
postpartum day at the postnatal units. Women will be provided with essential information on
the nature of the study and invited to complete the EPDS. Women who score above 9 on EPDS
are considered at risk of postnatal depression and they will be invited to participate in
the study. Verbal and written explanations of the purpose and the procedure of the study
will be provided by the research nurse and written consent will be obtained from women who
agree to participate in the study. Participants will be asked to complete the baseline
measures, including EPDS and SF-12. Post-test measures will be collected at 6 weeks and 6
months postpartum through mail.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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