title: Preventing perinatal depression in low-income home visiting clients: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the efficacy of a 6-week cognitive-behavioral intervention in preventing the onset of perinatal depression and reducing depressive symptoms among low-income women in home visitation programs.
  
  
  METHODS
  Sixty-one women who were pregnant or who had a child less than 6 months of age and who were assessed as at risk for perinatal depression were randomized to a 6-week, group-based cognitive-behavioral intervention or usual home visiting services. Study participants were predominately African American, unmarried, and unemployed. Intervention sessions were led by a licensed clinical social worker or clinical psychologist. Home visitors provided 1-on-1 reinforcement of key intervention messages between group sessions. Depressive symptoms were measured with the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996), and major depressive episodes were measured with the Maternal Mood Screener (MMS; Le & Muñoz, 1998). Outcomes were assessed at baseline and at 1 week and 3 months postintervention.
  
  
  RESULTS
  Repeated measures analysis of variance indicated that there was a significant Time × Condition interaction, F(2, 112) = 4.1, p = .02. At 3 months postintervention, 9 of 27 (33%) women receiving usual care reported levels of depressive symptoms that met clinical cutoff for depression on the MMS compared with 3 of 32 (9%) women in the intervention condition, χ²(1, N = 59) = 5.18, p < .05.
  
  
  CONCLUSIONS
  This study provides preliminary data on the efficacy of a cognitive-behavioral intervention to prevent perinatal depression among home visiting clients and suggests it is feasible to embed such an intervention in home visitation programs. A larger trial is warranted to attempt to replicate study findings.
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. standon@jhmi.edu
authors.forename: S Darius
authors.initials: SD
authors.lastname: Tandon
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Perry
authors.forename: Tamar
authors.initials: T
authors.lastname: Mendelson
authors.forename: Karen
authors.initials: K
authors.lastname: Kemp
authors.forename: Julie A
authors.initials: JA
authors.lastname: Leis
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D006792:House Calls; D006801:Humans; D011181:Postnatal Care / Q000379:methods / Q000523:psychology; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000523:psychology; D012054:Reinforcement, Psychology; D055815:Young Adult