Effectiveness of a Web-based Nursing Intervention in the Reduction of Postpartum Depression and Parenting Stress.

Study Overview
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Brief Summary
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The purpose of the study is to determine whether a web-based nursing intervention delivered during the postpartum period will decrease symptoms of postpartum depression and parenting stress.

Detailed Description
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The purpose of this randomized, controlled trial is to determine whether receiving standardized messages (text or email) from a postpartum nurse four times/week for 6 months after delivery will decrease symptoms of postpartum depression and parenting stress. Enrolled women will be randomized to one of three groups. The first group will receive the usual care, which is a phone call from a nurse within the first few weeks postpartum. The second group will receive four standardized messages each week, the content of which will include infant care, maternal self-care and inspirational material. The third group will receive the same four standardized messages each week, and in addition, two of these weekly messages will offer the option to respond with a request for a nurse to call them. Baseline data will be collected during the postpartum hospitalization, and follow-up will occur by email at 3 weeks, 3 months and 6 months postpartum.

Official Title
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Enhancing Follow-up Mechanisms for Women at Risk for Postpartum Depression

Conditions
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Depression, Postpartum

Intervention / Treatment
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* Behavioral: standardized electronic messages
* Behavioral: nurse phone call if requested
* Behavioral: Staff nurse phone follow-up


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Able to speak and read English Access to a device which can receive text or email messages Exclusion Criteria: Non-English speaking, No access to a device which can receive text or email messages Age younger than 18 -

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Usual care<br>Participant will receive the usual care provided by the nursing staff at Catholic Medical Center. A lactation consultant or childbirth educator attempts to call each patient within 2-3 weeks prior to discharge. Only one call is made, and a message left if the patient would like to call back. | Behavioral: Staff nurse phone follow-up<br>* Usual care: hospital nurse or lactation consultant calls patient within 2-3 weeks prior to discharge. Message left if patient is not reached.<br>|
| Experimental: Message Only<br>Participant will receive the usual care, and in addition, will receive four standardized electronic messages weekly for six months postpartum. These will be one-way messages without the option to respond. | Behavioral: standardized electronic messages<br>* supportive and educational short messages<br>* Other names: email messages;Behavioral: Staff nurse phone follow-up<br>* Usual care: hospital nurse or lactation consultant calls patient within 2-3 weeks prior to discharge. Message left if patient is not reached.<br>|
| Experimental: Message and Nurse<br>Participant will receive the usual care as well as the four standardized electronic messages/week for 6 months. Two of these weekly messages will be two-way, providing the option for the participant to respond yes to an offer to have a nurse call them. A nurse phone call if requested will be provided with a week. | Behavioral: standardized electronic messages<br>* supportive and educational short messages<br>* Other names: email messages;Behavioral: nurse phone call if requested<br>* If participant responds yes to an offer for a phone call, a nurse calls them within a week of this response<br>Behavioral: Staff nurse phone follow-up<br>* Usual care: hospital nurse or lactation consultant calls patient within 2-3 weeks prior to discharge. Message left if patient is not reached.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postpartum depression symptoms | Measured by scores on the Edinburgh Postnatal Depression Scale (EPDS) at three time points | 6 months postpartum | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| breastfeeding outcomes | Duration and pattern of infant feeding | 6 months postpartum | 
| patient satisfaction/experience | Participant response to the experience of receiving messages and having the option to talk to a nurse (group 3), as well as their sense of connection to the hospital where they gave birth | 6 months postpartum | 
| Parenting stress | Scores on the Parenting Stress Index (PSI-4) | 6 months postpartum | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nursing, postpartum, follow-up