Title

PRogram In Support of Moms (PRISM): a pilot group randomized controlled trial of two approaches to improving depression among perinatal women

UMMS Affiliation

Department of Psychiatry; Systems and Psychosocial Advances Research Center; Department of Obstetrics and Gynecology; Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Family Medicine and Community Health; Department of Quantitative Health Sciences

Date

10-10-2017

Document Type

Article

Disciplines

Maternal and Child Health | Mental and Social Health | Obstetrics and Gynecology | Psychiatry | Psychiatry and Psychology | Translational Medical Research | Women's Health

Abstract

PURPOSE: This pilot study was designed to inform a larger effectiveness trial by: (1) assessing the feasibility of the PRogram In Support of Moms (PRISM) and our study procedures; and, (2) determining the extent to which PRISM as compared to an active comparison group, the Massachusetts Child Access Psychiatry Program (MCPAP) for Moms alone, improves depression among perinatal women.

METHODS: Four practices were randomized to either PRISM or MCPAP for Moms alone, a state-wide telephonic perinatal psychiatry program. PRISM includes MCPAP for Moms plus implementation assistance with local champions, training, and implementation of office prompts and procedures to enhance depression screening, assessment and treatment. Patients with Edinburgh Postnatal Depression Scales (EPDS) > /= 10 were recruited during pregnancy, and completed the EPDS and a structured interview at baseline and 3-12 weeks' postpartum.

RESULTS: Among MCPAP for Moms alone practices, patients' (n = 9) EPDS scores improved from 15.22 to 10.11 (p = 0.010), whereas in PRISM practices patients' (n = 21) EPDS scores improved from 13.57 to 6.19 (p = 0.001); the between groups difference-of-differences was 2.27 (p = 0.341).

CONCLUSIONS: PRISM was beneficial for patients, clinicians, and support staff. Both PRISM and MCPAP for Moms alone improve depression symptom severity and the percentage of women with an EPDS > 10. The improvement difference between groups was not statistically significant due to limited power associated with small sample size.

Rights and Permissions

Citation: J Psychosom Obstet Gynaecol. 2017 Oct 10:1-10. doi: 10.1080/0167482X.2017.1383380. [Epub ahead of print] Link to article on publisher's site

Related Resources

Link to Article in PubMed

Keywords

UMCCTS funding, maternal depression, obstetrics, perinatal metal health, post-natal depression, mental health

PubMed ID

28994626