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Maternal Mental Health Access - MaMa

Not Applicable
Recruiting
Conditions
Postpartum Depression
Perinatal Depression
Interventions
Behavioral: Maternal Mental Health Access for Postpartum Depression- Prevention and UPLIFT- intervention
Behavioral: Arm 2
Behavioral: On-Demand + Discussion board (DB)
Behavioral: Arm 3
Behavioral: On Demand (OD) + Video Conference (VC)
Registration Number
NCT06049433
Lead Sponsor
University of Utah
Brief Summary

This hybrid effectiveness-implementation project will allow the team to evaluate and refine implementation in preparation for future multisite trials to ultimately move the Evidence-Based Intervention (EBI) to scale among diverse populations. The plan is to enroll 120 at-risk pregnant and postpartum women from rural, urban, and Latino populations. Using a randomized preference design to also evaluate patient and sociocultural factors in participation and symptom trajectory.

Using the Implementation Research Logic Model, the team will evaluate the implementation feasibility and acceptability of a remote-access and on-demand MBCT PD prevention intervention that is integrated within maternal clinical care settings using an existing patient portal. Successful achievement of the study aims will result in a refined implementation protocol for future studies that are sufficiently powered to evaluate the effectiveness of an integrated Digital Mental Health Technology and to estimate the cost/benefit ratio

Detailed Description

This type1 hybrid effectiveness-implementation project is conducted within healthcare settings and underserved populations (rural, urban, and Latino) and for individuals who are at risk for perinatal depression (PD), which allows the team to refine the approach in preparation for a future effectiveness trial for the prevention of PD in diverse communities using accessible Digital Mental Health Technology (patient education portal, FB discussion boards, synchronous videoconference support sessions). The plan is to adopt a randomized preference trial design to assess the impact of patient preference and sociocultural factors (including race, ethnicity, and geographic residence) on engagement and preliminary results. This information is crucial for a subsequent trial and for ultimately taking the intervention to scale. The study design using the IRLM reflects scientific rigor that can be reproduced by other investigators. The implemented strategies specifically developed to optimize implementation success, and to measure the implementation outcomes of these strategies and include valuable input from key informants, stakeholders, and the Community Advisory Board at regular intervals throughout the project time period.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
120
Inclusion Criteria
  • 18+ years of age, who at the time of screening
  • Have a viable pregnancy or are postpartum (up to 1 year)
  • Identified as at-risk for PD (any one of the following:
  • EPDS score equal to or greater than 9 or less than 21
  • History of depression/anxiety
  • 2 or more significant life events)
  • English- or Spanish-speaking
  • Currently attending a UHealth clinic or rural public health partner clinic.
Exclusion Criteria
  • Have a substance use disorder
  • Current diagnosis of serious mental illness, such as psychosis, schizophrenia, bipolar disorder, severe depression (including EPDS > 20)
  • Severe anxiety, suicidality, or currently taking any medications for a mental health condition.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Choice 1Maternal Mental Health Access for Postpartum Depression- Prevention and UPLIFT- interventionOptions; On-Demand (OD) alone or On-Demand (OD) with a facilitated discussion board (DB)
Choice 2Arm 2Options: On-Demand (OD) + Discussion board (DB) or OD + Video Conference (VC)
Choice 2Maternal Mental Health Access for Postpartum Depression- Prevention and UPLIFT- interventionOptions: On-Demand (OD) + Discussion board (DB) or OD + Video Conference (VC)
Choice 1On-Demand + Discussion board (DB)Options; On-Demand (OD) alone or On-Demand (OD) with a facilitated discussion board (DB)
Choice 3On Demand (OD) + Video Conference (VC)Options; Om-Demand (OD) or On-Demand (OD) + Video Conference (VC)
Choice 2On Demand (OD) + Video Conference (VC)Options: On-Demand (OD) + Discussion board (DB) or OD + Video Conference (VC)
Choice 3Arm 3Options; Om-Demand (OD) or On-Demand (OD) + Video Conference (VC)
Choice 3Maternal Mental Health Access for Postpartum Depression- Prevention and UPLIFT- interventionOptions; Om-Demand (OD) or On-Demand (OD) + Video Conference (VC)
Primary Outcome Measures
NameTimeMethod
Implementation outcome; Feasibility and acceptability(6, 12 & 18 months)

EPDS Scores are between 0 and 30, with scores 13 and above indicating depressive illness, or a high risk of developing a depressive disorder. Using scores that are between 9-20 Qualitative; semi structured interview Quantitative; patient satisfaction survey, number of referrals for at-risk patients, patients registering on YoMingo. focus groups, individual interviews, questionnaires

Secondary Outcome Measures
NameTimeMethod
Sociocultural Determinants and Behavior6, 12 & 18 months)

EPDS Scores are between 0 and 30, with scores 13 and above indicating depressive illness, or a high risk of developing a depressive disorder.- using EPDS score between 9-20. Life events, cultural/ethnical/racial group membership, history of depression, mental stigma

Trial Locations

Locations (1)

University of Utah

🇺🇸

Salt Lake City, Utah, United States

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