title: Problem-solving education to prevent depression among low-income mothers of preterm infants: a randomized controlled pilot trial.
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.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA. michael.silverstein@bmc.org
authors.forename: Michael
authors.initials: M
authors.lastname: Silverstein
authors.forename: Emily
authors.initials: E
authors.lastname: Feinberg
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.forename: Sara
authors.initials: S
authors.lastname: Sauder
authors.forename: Lucia
authors.initials: L
authors.lastname: Egbert
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schainker
authors.forename: Karen
authors.initials: K
authors.lastname: Kamholz
authors.forename: Mark
authors.initials: M
authors.lastname: Hegel
authors.forename: William
authors.initials: W
authors.lastname: Beardslee
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019052:Depression, Postpartum / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009035:Mothers / Q000193:education* / Q000523:psychology; D007752:Obstetric Labor, Premature / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011181:Postnatal Care / Q000379:methods; D011203:Poverty; D011247:Pregnancy; D011340:Problem Solving; D018794:Problem-Based Learning / Q000379:methods*; D012649:Self Concept; D055815:Young Adult