Abstract
We sought to assess the feasibility and document key study processes of a problem-solving intervention to prevent depression among low-income mothers of preterm infants. A randomized controlled pilot trial (n = 50) of problem-solving education (PSE) was conducted. We assessed intervention provider training and fidelity; recruitment and retention of subjects; intervention acceptability; and investigators' ability to conduct monthly outcome assessments, from which we could obtain empirical estimates of depression symptoms, stress, and functioning over 6 months. Four of four bachelor-level providers were able to deliver PSE appropriately with standardized subjects within 4 weeks of training. Of 12 randomly audited PSE sessions with actual subjects, all met treatment fidelity criteria. Nineteen of 25 PSE subjects (76%) received full four-session courses; no subjects reported negative experiences with PSE. Eighty-eight percent of scheduled follow-up assessments were completed. Forty-four percent of control group mothers experienced an episode of moderately severe depression symptoms over the follow-up period, compared to 24% of PSE mothers. Control mothers experienced an average 1.19 symptomatic episodes over the 6 months of follow-up, compared to 0.52 among PSE mothers. PSE appears feasible and may be a promising strategy to prevent depression among mothers of preterm infants.
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Acknowledgments
We thank Howard Bauchner, MD and Barry Zuckerman, MD for their thoughtful review of the manuscript; Pamela Rosenkranz, RN for her practical guidance on study implementation; Ellen Nylen, RN for her hard work enrolling study subjects; Jonathan Davis, MD for his support for the project; Robin Young, PhD for her help in data analysis; and Kathryn Barnard, PhD for her ongoing advice. This study was funded by the National Institute of Child Health and Human Development (R03HD058075), the Hood Foundation, and the Robert Wood Johnson Foundation under its Physician Faculty Scholars Program. Dr. Silverstein also receives support from the National Institute of Mental Health (K23MH074079). Dr. Feinberg receives support from the National Institute of Nursing Research (K23NR010588).
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None of the funding organizations played a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
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Silverstein, M., Feinberg, E., Cabral, H. et al. Problem-solving education to prevent depression among low-income mothers of preterm infants: a randomized controlled pilot trial. Arch Womens Ment Health 14, 317–324 (2011). https://doi.org/10.1007/s00737-011-0222-6
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DOI: https://doi.org/10.1007/s00737-011-0222-6