Nurtured in Nature

Not Applicable

Completed

• Conditions: Environmental Exposure; Postpartum Depression; Pregnancy Related
• Interventions: Behavioral: Nature Coach Intervention

• Registration Number: NCT04146025
• Lead Sponsor: University of Pennsylvania

Brief Summary

The investigators pilot test a Nature Coach Intervention in a population of postpartum women, to increase the amount of time people spend outside in local nature, with the goal of preventing postpartum depression.

Detailed Description

Postpartum depression (PPD), characterized by feelings of sadness, irritability, and fatigue following the birth of a child, occurs in 10-15% of women. PPD peaks within the first 2-3 months following delivery, but can occur anytime in the first year, representing one of the most common complications of childbearing. The consequences go beyond impaired functioning for the woman, and include harmful effects on the cognitive and emotional development of the woman's infant. Despite this, many women are undiagnosed and do not get adequate treatment.

Living near and spending time in green space is associated with a host of mental health benefits, including reduced depression and improved well-being. Research has shown that women who live near more green space have improved birth outcomes such as higher birthweight infants.

Despite the growing body of evidence linking nature with improved mental health, spending time in green space is not a standard health promoting tool to address mental illness. Behavioral economics concepts have been used successfully in promoting other preventative health behaviors such as physical activity and healthy eating.

Study Timeline

• Study Start: 2019-09-12
• Study First Submitted: 2019-10-02
• Study First Submitted QC: 2019-10-29
• Study First Posted: 2019-10-31
• Primary Completion: 2020-02-24
• Study Completion: 2020-03-27
• Status Verified: 2020-11
• Last Update Submitted: 2020-11-23
• Last Update Posted: 2020-11-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 36

Inclusion Criteria

• 18 years old and older
• Delivery of a living child
• Ambulatory
• Live in West or Southwest Philadelphia
• Have a smart phone
• Able to understand and respond to an oral interview in English

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Exclusion Criteria

• Baby in Neonatal Intensive Care Unit
• Mother has not been in Intensive Care Unit pre/post-delivery
• Gestational age less than 37 weeks
• Department of Human Services involvement

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Nature Coach Intervention	Nature Coach Intervention	The Nature Coach Intervention consists of 3 components - home visit, text message follow up, and goal feedback.

Primary Outcome Measures

Name	Time	Method
Green space use	3 months	This will be measured using Global Positioning System (GPS) data to see the amount of time spent in green space.

Secondary Outcome Measures

Name	Time	Method
Improvement in general well-being	3 months	This will be measured using the World Health Organization-5 (WHO-5) Well-being Index. The WHO-5 Well-Being Index is a questionnaire that measures current mental well-being,with the time frame being the previous two weeks.This is five items rated on 6-point Likert scale (All of the time, Most of the time, More than half the time, Less than half the time, Some of the time, At no time). The raw score is calculated by totaling the figures of the five answers. The raw score ranges from 0 to 25, 0 representing worst possible and 25 representing best possible quality of life.
Prevention of postpartum depression	3 months	This will be measured using the Edinburgh Postnatal Depression Scale. The Edinburgh Postnatal Depression Scale is a 10-statement scale that was developed to identify women who may have postpartum depression. Each answer is given a score of 0 to 3.The maximum score is 30; Questions 1, 2, \& 4 are scored 0, 1, 2 or 3 with the first choice option scored as a 0 and the last choice option scored as 3. Questions 3, 5-10 are reverse scored, with the first choice option scored as a 3 and the last choice option scored as a 0. A score of 10 or more suggests that minor or major depression may be present.

Trial Locations

Locations (1)

University of Pennsylvania; 🇺🇸 Philadelphia, Pennsylvania, United States