In-home intervention for depressive symptoms with low-income mothers of infants and toddlers in the United States

The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina 27599-7460, USA.
Health Care For Women International (Impact Factor: 0.63). 07/2004; 25(6):561-80. DOI: 10.1080/07399330490444830
Source: PubMed


Depressive symptoms in low-income mothers negatively affect infant-toddler development. This pilot study tested a short-term, home-based depressive symptom intervention with 16 African American and White, Non-Hispanic mothers in Early Head Start (EHS) programs who were randomly assigned to intervention and usual care/waiting list conditions. Mothers met in their homes with master's-prepared psychiatric mental health nurses who worked with them to improve their management of depressive symptoms and life issues, use of social support, and parenting. The intervention group showed a significantly greater decrease from baseline in depressive symptom severity at 8 and 16 weeks in contrast to the mothers receiving usual care. Observations of maternal interactions showed improvement in the intervention mothers. The results support testing on a larger scale.

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    • "Many of these families encounter considerable obstacles to accessing appropriate treatment, such as a lack of transportation, child care, and health care coverage. Given the low energy and motivation that characterize depression, as well as the social stigma of mental illness, parents with mental health issues may not have the personal, social, or financial resources to obtain care (Beeber et al., 2004; Love et al., 2005). Findings from EHSREP were consistent with prior research establishing a high incidence of stress, depression, and anxiety in families with certain demographic risk factors, many of which characterize the EHS eligible population (e.g., low income, parenting young children, minority background). "

    Health and education in early childhood: Predictors, interventions, and policies, 1st edited by A. J. Reynolds, A.J. Rolnick, J.A. Temple, 08/2015: chapter 9: pages 234-256; Cambridge University Press., ISBN: ISBN-13: 9781107038349
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    • "Yapılan çalışmalarda ruh sağlığı hemşireleri tarafından doğum sonrası depresyonu olan kadınlara ev ziyaretleri ile yapılan eğitim sonucunda, depresif belirtilerde önemli azalma, anne-çocuk etkileşiminde ilerleme ve kadınların yaşam kalitesinde artma olduğu tespit edilmiştir (Tamaki, 2008; Beeber ve ark., 2004). Ciddi sonuçlar doğurabilen doğum sonrası depresyonu önleme, erken tanı, sevk etme, tedavi ve bakımında hemşirelerin/ebelerin önemli sorumlulukları bulunmaktadır. "
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    ABSTRACT: Objective: This study aimed to investigate the relation between postpartum depression and social support and affecting factors. Material and Methods: This study was designed as a cross-sectional study. Edinburgh Postpartum Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and descriptive form was utilized for data collection. The study was performed at the polyclinic of obstetrics and gynecology in Erzincan State Hospital within October-December in 2006. Descriptive form, EPDS, MSPSS were used for interview with women face to face. The mothers of 0-12 month-old babies who have consulted the polyclinic within these months and who volunteered to take part in the study are included in the study (n=197). In evaluation of the data, percentage, Pearson Correlation, Kruskal Wallis, t test and Mann Withney-U tests were employed. Results: It is founded out that the average women’s age is 26.39±5.55, %80.2 of women were pregnant willing. In this study it is also founded at that 51.3% of the mothers are at risk of postpartum depression, and that the average points of depression risk is 12.36±5.76. A significant difference between the women’s spouses’ level of education and economic conditions and postpartum depression was found (p<0.05). Besides, it is determined that the total MSPSS average points of the women are 47.04±13.62, and that the average points of the subscale of social support which is special person (nurse) is 8.68±6.39. There is a significant relation among the social support points perceived by the sub-dimensions of postpartum depression and multidimensional scale of perceived social support, which are family, friends and special person (nurse) (p<0.001, p<0.01, p<0.05). Conclusion: It was ascertained that the postpartum depression risk, 51.3 % is higher than the limits given in literature. Also it was determined meaningful difference between postpartum depression and social support. It is important that the women posing postpartum depression be observed by the health workers and that the appropriate applications be made.
    • "Our initial search yielded 24 abstracts that appeared to meet the specified inclusion criteria; those articles were obtained and reviewed. Upon closer review of those 24 studies, seven were excluded because they reported on nonpsychological interventions (Armstrong et al. 1999; Armstrong et al. 2000; Fraser et al. 2000; Gelfand et al. 1996; Morrell et al. 2000; Navaie-Waliser et al. 2000; Roman et al. 2007), one was excluded because the sample was not restricted to mothers of children less than 1 year old (Beeber et al. 2004), one was excluded because there was no comparison group (Ammerman et al. 2005), two were excluded because assignment to intervention or control was not randomized (Austin et al. 1999; Cullinan 1991), two were excluded because they combined results for home-based and clinic-based services (Wickberg and Hwang 1996; Zayas et al. 2004), and another four studies were excluded because there was not enough information given to determine the specific type of intervention employed (Koniak-Griffin et al. 2002; Marcenko and Spence 1994; Marcenko et al. 1996; Tezel and Gözüm 2006). An overview and critique of the six articles meeting criteria for inclusion in the review are presented below. "
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    ABSTRACT: This systematic review evaluated randomized controlled trials assessing home-based psychological interventions to prevent and treat postpartum depression (PPD). Six studies meeting inclusion criteria were identified, five assessing treatments for PPD and one assessing a preventive intervention for PPD. Interventions used cognitive behavioral, psychodynamic, and non-directive counseling approaches. Of the six studies reviewed, four reported statistically significant treatment effects on PPD following the intervention. Each of the three types of psychological interventions were shown to reduce levels of maternal depression. Recommendations for future development and evaluation of home-based psychological interventions for PPD are discussed. These include identification of mediators and moderators of intervention efficacy, exploring strategies for prevention of PPD, and targeting high-risk groups.
    Archives of Women s Mental Health 02/2009; 12(1):3-13. DOI:10.1007/s00737-008-0039-0 · 2.16 Impact Factor
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