Online Program

Reducing symptoms of prenatal depression in an ethnically diverse group of rural low income women: A randomized clinical trial in progress

Monday, November 4, 2013

Elizabeth Feldhousen, MS, LMFT, East Carolina University, Greenville, NC
D. Elizabeth Jesse, PhD, CNM, College of Nursing Graduate Nursing Science, East Carolina University, Greenville, NC
Edward Newton, MD, Brody School of Medicine, East Carolina University, Greenville, NC
Shelia Bunch, MSW, PhD, School of Social Work, East Carolina University, Greenville, NC
Bradley Gaynes, MD/MPH, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
Mel Swanson, PhD, College of Nursing, East Carolina University, Greenville, NC
Jack Yazbeck, BS, Brody School of Medicine, East Carolina University, Greenville, NC
Background: Each year, as many as 50% of pregnant women experience depressive symptoms and about 11% develop antepartum depression (APD). Insight-Plus CBI (IP-CBI) is an innovative cognitive behavioral therapy intervention previously tested with a diverse group of low-income women. The program is delivered by a licensed mental health clinician and a case manager at the Local Health Department (LHD) and an affiliated clinic. Methods: This is an experimental two-group pre-test and post-test design. Chi-square tests of independence and independent-groups t-tests will be used to analyze differences in antepartum depressive symptoms (APDS) for women in the treatment group to APDS/APD symptoms to women in the treatment-as-usual (TAU) group after the last intervention session and at one month post intervention. Depressive symptoms are measured by the Edinburgh Postnatal Depression Scale (EPDS) and the MINI International Neuropsychiatric Interview. Results: Descriptive data includes 129 women out of a planned 140 participants who were interviewed at baseline. 68% were African-American and 32% Caucasian. Of these, 3% were Spanish speaking women who identified as ethnically Hispanic. Forty-four percent were at low-risk (EPDS 4-9) and 56% were at high-risk for APD (EPDS >10); 35% of the participants were diagnosed with APD. APDS and APD are major health issues. It is vital to develop interventions for these vulnerable women. Should this culturally tailored CBI prove to be feasible and effective, it will be a model for delivering care by public health staff and a model for care for low-income and minority women nationally.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe prevalence of antepartum depression among ethnically diverse low income rural women Discuss importance of providing accessible and culturally relevant and sensitive mental health treatment to this population

Keyword(s): Prenatal Care, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am responsible for because I am a doctoral candidate and the project manager for this intervention to reduce depressive symptoms in rural low income ethnically diverse pregnant women. Among my research interests are reducing health disparities for underserved populations, and I am particularly interested in programs designed to promote the well being of women and their children.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.