title: Reducing postpartum depressive symptoms among black and Latina mothers: a randomized controlled trial.
abstract: OBJECTIVE
  To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers.
  
  
  METHODS
  We recruited 540 self-identified black and Latina mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. Those in the intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participants' access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed before randomization and, 3 weeks, 3 months, and 6 months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater).
  
  
  RESULTS
  Positive depression screens were less common among intervention compared with enhanced usual care posthospitalization: 3 weeks (8.8% compared with 15.3%, P=.03), 3 months (8.4% compared with 13.24%, P=.09), and 6 months (8.9% compared with 13.7%, P=.11). An intention-to-treat repeated-measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression compared with enhanced usual care (odds ratio 0.67, 95% confidence interval [CI] 0.47-0.97; number needed to treat 16, 95% CI 9-112).
  
  
  CONCLUSIONS
  An action-oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers.
  
  
  BACKGROUND
  Clinicaltrials.gov, www.clinicaltrials.gov, NCT01312883.
  
  
  METHODS
  I.
authors.affiliation: Department of Health Evidence & Policy, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. elizabeth.howell@mountsinai.org
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Howell
authors.forename: Amy
authors.initials: A
authors.lastname: Balbierz
authors.forename: Jason
authors.initials: J
authors.lastname: Wang
authors.forename: Michael
authors.initials: M
authors.lastname: Parides
authors.forename: Caron
authors.initials: C
authors.lastname: Zlotnick
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D019052:Depression, Postpartum / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods*; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009519:New York City; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult