Effectiveness of Thinking Healthy Program for Prevention of Antenatal Depression
Condition: Post Partum Depression
MeSH terms: Depression, Postpartum; Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The trial is to evaluate the effect of an evidence-informed, depression focused early
      prenatal prevention intervention at six weeks' postpartum. Secondary objective is to explore
      demographical and psychosocial factors responsible for development of prenatal and postpartum
      depression. Investigator will also examine the potential mediators of depression and the
      effect of intervention on depression and its related factors i.e. marital relationship,
      social support, empowerment and history of intimate partner violence. Pregnant women coming
      for their antenatal visits to the Sheikh Zayed Hospital (SZH), a public facility in Lahore,
      Pakistan, will be screened for eligibility. Eligible women will be 24-26 weeks pregnancy who
      will be assessed as having mild to moderate levels of depression [i.e., score ≥10 on Personal
      Health Care Questionnaire (PHQ-9)] validated in Pakistan for the use of non-specialist.
    

Detailed description: 
      The present study aims to evaluate the effectiveness of evidence informed, depression focused
      early prenatal prevention intervention in pregnant women at six weeks' postpartum.
      Investigator hypothesize that women with subclinical to clinical levels of prenatal
      depression to the intervention will result in fewer cases of depression (mild to moderate) at
      six weeks' postpartum. The primary objective of the trial is to evaluate the effect of an
      evidence-informed, depression focused early prenatal prevention intervention at six weeks'
      postpartum. Secondary objective is to explore demographical and psychosocial factors
      responsible for development of prenatal and postpartum depression. We will also examine the
      potential mediators of depression and the effect of intervention on depression and its
      related factors i.e. marital relationship, social support, empowerment and history of
      intimate partner violence. Pregnant women coming for their antenatal visits to the Sheikh
      Zayed Hospital (SZH), a public facility in Lahore, Pakistan, will be screened for
      eligibility. Eligible women will be 24-26 weeks pregnancy who will be assessed as having mild
      to moderate levels of depression [i.e., score ≥10 on Personal Health Care Questionnaire
      (PHQ-9)] validated in Pakistan for the use of non-specialist.

      An intervention thinking Healthy Program (THP) will be done in which Investigator will enroll
      up to twenty (20) pregnant women. Low line psychosocial intervention based on the principles
      of Cognitive Behavior Therapy (CBT), designed for non-specialist will be applied for
      expectant women experiencing depression during mid to late-pregnancy. It uses the core
      principles and strategies of the Thinking Healthy Program (THP), an evidence-based
      psychosocial intervention for mothers experiencing perinatal depression, including empathetic
      listening, thought challenging, behavior activation, family involvement, and problem
      management. Additionally, stress management skills such as breathing exercises are
      incorporated. Culturally relevant customized illustrations are used for guided discovery,
      behavior activation, stress management, and to convey key health messages. The intervention
      is a series of one-on-one sessions, complemented by take home exercises. Before and after
      intervention comparison will be made to find out the efficacy of intervention. The data will
      be collected at one site: Sheikh Zayed Hospital, a public tertiary care facility in Lahore,
      Pakistan. It will take six months for data collection.
    

Intervention name(s): Thinking healthy Program sessions designed for antenatal period
Intervention type(s): Behavioral
Intervention description(s): Low line psychosocial intervention based on the principles of Cognitive Behavior Therapy (CBT), designed for non-specialist will be applied for expectant women experiencing depression during mid to late-pregnancy. It uses the core principles and strategies of the Thinking Healthy Program (THP). Four core sessions and two booster sessions will be applied, designed for antenatal period to prevent antenatal and post partum depression.
Other intervention name(s): Psychoeducation
Intervention model: Single Group Assignment
Intervention model description: Quasi experimental study
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Antenatal depression; psychosocial factors; Thinking Healthy Program