Center M Pilot Trial: Integrating Preventive Mental Health Care in Routine Prenatal Care.

Autor: Tilden EL; School of Nursing, Oregon Health & Science University, Portland, Oregon.; The Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon., Shank T; Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, Oregon.; Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon., Polan Orzech C; Mental Health Division, Center for Women's Health, Oregon Health & Science University, Portland, Oregon., Holmes LR; School of Nursing, Oregon Health & Science University, Portland, Oregon., Granados R; School of Nursing, Oregon Health & Science University, Portland, Oregon., Moosavisahebozamani S; School of Nursing, Oregon Health & Science University, Portland, Oregon., Starr D; Biomedical Innovation Program, Oregon Health & Science University, Portland, Oregon.; Center Mom, Inc, Oregon Health & Science University, Portland, Oregon., Caughey AB; School of Nursing, Oregon Health & Science University, Portland, Oregon.; The Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon., Graham AM; Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, Oregon., Mackiewicz Seghete KL; The Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.; Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, Oregon.; Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon.
Jazyk: angličtina
Zdroj: Journal of midwifery & women's health [J Midwifery Womens Health] 2024 Nov-Dec; Vol. 69 (6), pp. 906-916. Date of Electronic Publication: 2024 Nov 27.
DOI: 10.1111/jmwh.13709
Abstrakt: Introduction: Perinatal depression is a leading cause of preventable US maternal morbidity and mortality. Although Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) is highly effective, it faces significant scalability challenges. Center M, a brief, group-based, mindfulness-based cognitive behavioral therapy (CBT) intervention, is an adaptation of MBCT-PD designed to overcome these challenges. The purpose of this pilot study was to evaluate Center M's preliminary acceptability, feasibility, mechanisms of action, and efficacy.
Methods: In this mixed-methods pilot study, data were collected from 99 pregnant people at 3 time points: preintervention, postintervention, and 6-weeks postpartum (Clinical Trials no. NCT06525922). Participants engaged in 4 one-hour, weekly group telehealth Center M sessions facilitated by social workers. Participants strengthened mindfulness CBT skills using home practice materials between group sessions. Data included self-report measures evaluating depressive symptoms, mindfulness skills, and emotion regulation. Satisfaction was assessed via focus groups or surveys.
Results: Depressive symptoms significantly decreased preintervention to postintervention (Patient Health Questionnaire-8 score: preintervention mean [SD] 5.02 [3.52], postintervention mean [SD] 4.23 [2.84]; P = .03), and mindfulness capacity significantly increased preintervention to 6 weeks postpartum (Five Facets of Mindfulness Questionnaire score: preintervention mean [SD] 125.56 [18.68], 6 weeks postpartum mean [SD] 130.10 [17.15]; P = .004). Linear regression analyses indicate that higher mindfulness at 6 weeks postpartum significantly predicted fewer depression symptoms at 6 weeks postpartum (β, -0.07; 95% CI, -0.123 to -0.021, R 2 = 0.22; P = .006). Reduction in the use of maladaptive emotion regulation was significantly associated with decreased depressive symptoms at 6 weeks postpartum (β, 0.21; 95% CI, 0.048 to 0.376, R 2 = .21; P = .012). Qualitative themes indicated high Center M acceptability and appeal.
Discussion: Our findings support the feasibility, acceptability, and appeal of Center M. Results suggest Center M may be effective in reducing depression and enhancing mindfulness skills. Future research must confirm these initial findings to more widely address Center M implementation capacity and sustainability.
(© 2024 by the American College of Nurse‐Midwives.)
Databáze: MEDLINE
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