Skip to main content

Advertisement

SpringerLink
Log in

Preventing Perinatal Depression in High Risk Women: Moving the Mothers and Babies Course from Clinical Trials to Community Implementation

  • Notes from the Field
  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

A growing research literature highlights the public health need for preventive interventions to reduce symptoms and incidence of perinatal depression among vulnerable populations. The Mothers and Babies (MB) course is a cognitive–behavioral intervention designed to teach mood regulation skills to English- and Spanish-speaking low-income women at high risk for perinatal depression. We describe the development of the MB course and evaluate the extent to which research findings support efficacy, effectiveness, and dissemination based on the Society for Prevention Research Standards Committee’s standards of evidence. Our review of research and implementation activities suggests that the MB intervention demonstrates promising evidence for efficacy in reducing depressive symptoms; empirical support for prevention of major depressive episodes is still preliminary. Work is in progress to evaluate program effectiveness and prepare for broad dissemination and implementation. The MB course shows promise as an intervention for low-income women at risk for perinatal mood issues. Spanish and English intervention materials have been developed that can be delivered in different settings (hospitals, home visiting), in different dosages (6, 8, or 12 sessions), and via different modalities (group, individual). Evaluating the MB course against current standards is intended to inform other prevention intervention development research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Notes

  1. Information on randomization, measures, and intervention implementation are described in more detail in each of the references of the three trials

References

  1. Goodman, S. H., & Brand, S. R. (2009). Depression and early adverse experiences. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (2nd ed., pp. 249–274). New York: Guilford Press.

    Google Scholar 

  2. Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(5, Part 1), 1071–1083.

    Article  Google Scholar 

  3. Hutto, H. F., Kim-Godwin, Y., Pollard, D., & Kemppainen, J. (2011). Postpartum depression among White, African American, and Hispanic low-income mothers in rural Southeastern North Carolina. Journal of Community Health Nursing, 28(1), 41–53.

    Article  PubMed  Google Scholar 

  4. Howell, E. A., Mora, P. A., Horowitz, C. R., & Leventhal, H. (2005). Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstetrics and Gynecology, 105(6), 1442–1550.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Seguin, L., Potvin, L., St-Denis, M., & Loiselle, J. (1999). Depressive symptoms in the late postpartum among low socioeconomic status women. Birth, 26(3), 157–163.

    Article  CAS  PubMed  Google Scholar 

  6. Flynn, H. A., Blow, F. C., & Marcus, S. M. (2006). Rates and predictors of depression treatment among pregnant women in hospital-affiliated obstetrics practices. General Hospital Psychiatry, 28(4), 289–295.

    Article  PubMed  Google Scholar 

  7. Leis, J. A., Mendelson, T., Perry, D. F., & Tandon, S. D. (2011). Perceptions of mental health services among low-income, perinatal African-American women. Women’s Health Issues, 21, 314–319.

    Article  PubMed  Google Scholar 

  8. Nadeem, E., Lange, J. M., Edge, D., Fongwa, M., Belin, T., & Miranda, J. (2007). Does stigma keep poor young immigrant and U.S.-born Black and Latina women from seeking mental health care? Psychiatric Services, 58(12), 1547–1554.

    Article  PubMed  Google Scholar 

  9. National Research Council and Institute of Medicine. (2009). Depression in parents, parenting and children: Opportunities to improve identification, treatment and prevention. Washington, DC: The National Academies Press.

    Google Scholar 

  10. Field, T. (2010). Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behavior and Development, 33(1), 1–6.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Sohr-Preston, S. L., & Scaramella, L. V. (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology Review, 9(1), 65–83.

    Article  PubMed  Google Scholar 

  12. Muñoz, R. F., Schueller, S. M., Barrera, A. Z., Le, H. N., & Torres, L. (2014). Major depression can be prevented: Implications for research and practice. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (3rd ed., pp. 471–491). New York: The Guilford Press.

    Google Scholar 

  13. Jané-Llopis, E., Hosman, C., Jenkins, R., & Anderson, P. (2003). Predictors of efficacy in depression prevention programmes: Meta-analysis. British Journal of Psychiatry, 183, 384–397.

    Article  PubMed  Google Scholar 

  14. Mrazek, P. J., & Haggerty, R. J. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academies Press.

    Google Scholar 

  15. Battle, C. L., & Zlotnick, C. (2005). Prevention of postpartum depression. Psychiatric Annals, 35, 590–598.

    Article  Google Scholar 

  16. Brugha, T. S., Morrell, C. J., Slade, P., & Walters, S. J. (2011). Universal prevention of depression in women postnatally: Cluster randomized trial evidence in primary care. Psychological Medicine, 41(4), 739–748.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Dennis, C., & Dowswell, T. (2013). Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001134. doi:10.1002/14651858.CD001134.pub3

  18. Sockol, L. E., Epperson, C. N., & Barber, J. P. (2013). Preventing postpartum depression: A meta-analytic review. Clinical Psychology Review, 33(8), 1205–1217.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Le, H. N., Muñoz, R. F., Soto, J. A., Delucchi, K. L., & Ippen, C. G. (2004). Identifying risk for onset of major depressive episodes in low-income Latinas during pregnancy and postpartum. Hispanic Journal of Behavioral Sciences, 26(4), 463–482.

    Article  Google Scholar 

  20. Muñoz, R. F., Cuijpers, P., Smit, F., Barrera, A. Z., & Leykin, Y. (2010). Prevention of major depression. Annual Review of Psychology, 6, 181–212.

    Article  Google Scholar 

  21. Le, H. N., Perry, D. F., & Stuart, E. A. (2011). Evaluating a preventive intervention for perinatal depression in high-risk Latinas. Journal of Consulting and Clinical Psychology, 79(2), 135–141.

    Article  PubMed  Google Scholar 

  22. Muñoz, R. F., Le, H. N., Ghosh Ippen, C., Diaz, M. A., Urizar, G., Soto, J., et al. (2007). Prevention of postpartum depression in low-income women: Development of the Mamás y Bebés/Mothers and Babies Course. Cognitive and Behavioral Practice, 14, 70–83.

    Article  Google Scholar 

  23. Tandon, S. D., Mendelson, T., Kemp, K., Leis, J., & Perry, D. F. (2011). Preventing perinatal depression in low-income home visiting clients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 79(5), 707–712.

    Article  PubMed  Google Scholar 

  24. Flay, B. R., Biglan, A., Borch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness, and dissemination. Prevention Science, 6(3), 151–175.

    Article  PubMed  Google Scholar 

  25. Dimidjian, S., Barrera, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38.

    Article  PubMed  Google Scholar 

  26. Lewinsohn, P. M., Muñoz, R. F., Youngren, M. A., & Zeiss, A. M. (1986). Control your depression (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  27. Ainsworth, M. D., Blehar, M., Waters, E., & Wall, B. (1978). Patterns of attachment. Hillsdale: Erlbaum.

    Google Scholar 

  28. Muñoz, R. F. (1996). The healthy management of reality. Retrieved from http://medschool2.ucsf.edu/latino/pdf/healthy_management.pdf

  29. Le, H. N., Zmuda, J., Perry, D. F., & Muñoz, R. F. (2010). Transforming an evidence-based intervention to prevent perinatal depression for low-income Latina immigrants. American Journal of Orthopsychiatry, 80(1), 34–45.

    Article  PubMed  Google Scholar 

  30. Urizar, G. G., & Muñoz, R. F. (2015). Role of maternal depression on child development: A prospective analysis from pregnancy to early childhood. Manuscript submitted for publication. http://blog.apastyle.org/apastyle/2010/01/the-generic-reference-when.html.

  31. Urizar, G. G., & Muñoz, R. F. (2011). Impact of a prenatal cognitive–behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology, 36(10), 1480–1494.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Tandon, S. D., Leis, J., Mendelson, T., Perry, D. F., & Edwards, K. (2014). 6-month outcomes from a randomized controlled trial to prevent perinatal depression in low-income home visiting clients. Maternal and Child Health Journal, 18(4), 873–881.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Israel, B. A., Eng, E., Schulz, A. J., & Parker, E. A. (2005). Introduction in methods for community based participatory research in health. In B. A. Israel, E. Eng, A. J. Schulz, & E. A. Parker (Eds.), Methods in community-based participatory research for health (pp. 3–26). San Francisco, CA: Jossey Bass.

    Google Scholar 

  34. Snyder, H., Lorente Molina, M. T., Perry, D. F., & Le, H. N. (2013). Fidelity evaluation of a cognitive–behavioral based course preventing perinatal depression. Poster presented at the bi-annual meeting of the Marcé Society for Perinatal Mental Health, Chicago, IL.

  35. Dowrick, C., Dunn, G., Ayuso-Mateos, J. L., Dalgard, O. S., Page, H., Lehtinen, V., & Wilkinson, G. (2000). Problem solving treatment and group psychoeducation for depression: Multicentre randomised controlled trial. British Medical Journal, 321, 1450–1456.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by Grant R40 MC17179 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services (PI: Le). Special thanks to Manuela Diaz, Karen Edwards, Julie Leis, Adriana Ortiz de Raet, and Paula Valenzuela.

Author information

Authors and Affiliations

  1. George Washington University, Washington, DC, USA

    Huynh-Nhu Le

  2. Georgetown University, Washington, DC, USA

    Deborah F. Perry

  3. Johns Hopkins University, Baltimore, MD, USA

    Tamar Mendelson

  4. Northwestern University, Evanston, IL, USA

    S. Darius Tandon

  5. Palo Alto University, Palo Alto, CA, USA

    Ricardo F. Muñoz

  6. University of California, San Francisco, San Francisco, CA, USA

    Ricardo F. Muñoz

Authors
  1. Huynh-Nhu Le
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deborah F. Perry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tamar Mendelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Darius Tandon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ricardo F. Muñoz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Huynh-Nhu Le.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Le, HN., Perry, D.F., Mendelson, T. et al. Preventing Perinatal Depression in High Risk Women: Moving the Mothers and Babies Course from Clinical Trials to Community Implementation. Matern Child Health J 19, 2102–2110 (2015). https://doi.org/10.1007/s10995-015-1729-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1729-7

Keywords

Search

Navigation