Depression Clinical Trial
Official title:
For Moms: Culturally Relevant Treatment Services for Perinatal Depression
The study will evaluate the effectiveness of a culturally relevant, multi-component intervention for antenatal depression. The intervention includes an engagement session, and the woman's choice of brief interpersonal psychotherapy and/or pharmacotherapy in a stepped care treatment for depression model.
The randomized control trial will evaluate the effects of a culturally relevant,
multi-component intervention for antenatal depression. MOMCare has the potential to overcome
patient, provider, and system-level barriers to care and engage depressed, low-income women
in evidence-based treatments to reduce antenatal depressive symptoms, improve maternal
psychosocial functioning, and ameliorate postpartum depression. Specific Aim 1: To evaluate
the impact of MOMCare on treatment engagement and retention. Specific Aim 2: To evaluate the
impact of MOMCare on maternal clinical symptoms and functional outcomes. Specific Aim 3: To
conduct an incremental cost-effectiveness analysis for a health care and welfare agency
perspective that includes a) tracking the medical costs of health service use in MOMCare and
usual care patients; b) monitoring the use of infant preventative health services in both
groups; and c) tracking the percentage of women on Medicaid and the percentage working in
both groups.
The intervention will be assessed through a practical randomized controlled trial in which
we have recruited 168 pregnant women with major depression and/or dysthymia who were on
Medicaid and/or received Maternal Support Services (MSS) in selected public health centers
in Seattle - King County (PHSKC). Patients who were eligible and consented to study
enrollment were randomly assigned to either usual care (UC) or MOMCare. Baseline and four
follow-up assessments (3 - 18 months post-baseline) are scheduled for study participants in
both groups. The MOMCare intervention includes a choice of brief interpersonal psychotherapy
or collaborative management of antidepressant medication. Treatment response will be
monitored, and the treatment will be adjusted as necessary (adding treatments, increasing
dosages).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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