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Saturday, October 31, 2009: 3:55 PM
Learning Objective 1: have greater understanding of disparities in antepartum depressive symptoms among African-American and Caucasian rural low-income women.
Learning Objective 2: describe enrollment barriers, retention, feasibility, and preliminary outcomes of Insight-Plus CBI pilot study for reducing depressive symptoms in pregnancy and postpartum.
Background: Depression during pregnancy is a common and persistent problem resulting in tremendous personal suffering, greater psychosocial and behavioral risks, adverse birth outcomes, and the development of postpartum depression. Design: The pilot study uses a quasi-experimental two-group pre-post design with repeated measures and includes post intervention qualitative interviews. Sample/setting: A convenience sample of 30 African-American and Caucasian rural low-income women enrolled in prenatal clinics in Eastern North Carolina who scored 10 or above on the Edinburgh Postnatal Depression Scale (EPDS) at the initial screening, spoke English, and met other eligibility criteria. Methods: Insight-Plus, facilitated by mental health professionals, met for 6 weekly 2-hour sessions. Women in the intervention and treatment as usual (TAU) comparison group were interviewed at baseline; 4 weeks post intervention to determine risk of depression in pregnancy, and 4 and 8 weeks postpartum to determine risk for PPD using valid and reliable instruments and qualitative interviews. Results: Recruitment barriers and challenges included level of engagement at interview, scheduling, and maintaining telephone contact. Once enrolled 24 (100%) women who came to the first Insight-Plus session completed all six intervention sessions and 85% (17/20) of the intervention women completed their T3 interview (one-month post intervention); 100% (4/4) of the women in the TAU group completed their T3 interview. From baseline to one month post-intervention (T3) the mean EPDS scores for the intervention group changed from 15.50 (SD 3.15) to 7.25 (4.24, p <.001) while, the mean scores in TAU comparison group changed from 14.00 (SD 4.24) to 11.25 (SD 7.04, NS); at 4 and 8 weeks postpartum the mean EPDS scores were 7.30 (SD 6.52) and 7.3 (SD 6.33, p=<.001 and p<.01) Conclusions: This pilot study was feasible and helpful to low-income women at risk for depression and holds promise for reducing risk of antepartum and postpartum depression.