A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

Abstract

Introduction Perinatal depression occurs in 12% to 18% of childbearing women. Telehealth is a promising platform for delivering perinatal mental health care, particularly during a pandemic when in‐person services have been significantly curtailed. However, there is little research to document the feasibility of telehealth to address perinatal depression. This pilot study evaluated the feasibility and preliminary results of an 8‐week facilitated group videoconference intervention. Methods The study enrolled pregnant and postpartum women into an 8‐week group mindfulness‐based cognitive behavioral intervention, delivered via videoconference platform. Women receiving care at outpatient clinics who either screened positive for perinatal depression symptoms or had risk factors predictive of perinatal depression were invited to participate. Women attended weekly one‐hour group sessions using their own electronic device and completed the Edinburgh Postnatal Depression Scale (EPDS) at several time points. Session attendance and survey completion rates were evaluated. Results A total of 47 women enrolled (8 postpartum; 39 prenatal) into groups of 4 to 6. Twenty‐four (51.1%) women were currently experiencing mild to moderate perinatal depression symptoms (EPDS score of 10‐20), whereas 23 (48.9%) women had EPDS scores less than 10 but were at high risk for developing perinatal depression due to health history and significant life events. Seventy percent of women attended at least 5 of the 8 sessions. Trajectories of EPDS measures were promising (ie, downward among those with current perinatal depression symptoms and stable among those at high risk for developing perinatal depression). Discussion These observational results are promising, suggesting further study of effectiveness for women with symptoms of perinatal depression, as well as for women at high risk for developing perinatal depression. Randomized trials could evaluate the effectiveness of the intervention, compared with standard of care approaches. Telehealth interventions can be tailored to meet the needs of different communities, and increase access to care, regardless of where women live or inability to receive in‐person services.

Telehealth adaptation of perinatal mental health mother–infant group programming for the COVID‐19 pandemic

“…authors argued that the transition to telehealth was disruptive to consistency of care, which this high-risk group of pregnant women with opioid use difficulties particularly required (McKiever et al, 2020). A small study piloting the delivery via videoconferencing of an effective in-person mindfulness-based cognitive behavioral therapy (CBT) group for women in the perinatal period for treatment of postpartum depression found that delivery via virtual format was effective based on results of decrease in Edinburgh Postnatal Depression Scale (EPDS) pre-and post-intervention (Latendresse et al, 2021). Notably, public awareness of health disparities and societal inequities has increased due to the disproportionate impact of the COVID-19 pandemic on people of color, especially, Black, Hispanic, Native American, and Asian populations being up to 3.4 times more likely to be hospitalized due to COVID-19 than their White counterparts (CDC, 2021;Rubin-Miller et al, 2020).…”

“…This may produce competing needs during the time of telehealth visits with attending to other children. Latendresse et al (2021) found in their study that one cause of intervention dropout, or nonparticipation after starting a group, was reported by participants to be due to ". .…”

“…Latendresse et al. ( 2021 ) found in their study that one cause of intervention dropout, or nonparticipation after starting a group, was reported by participants to be due to “…frustration with connecting with the videoconference intervention platform, [and] could not figure out how to ‘keep kids quiet when attending’…”…”

“…These authors argued that the transition to telehealth was disruptive to consistency of care, which this high‐risk group of pregnant women with opioid use difficulties particularly required (McKiever et al., 2020 ). A small study piloting the delivery via videoconferencing of an effective in‐person mindfulness‐based cognitive behavioral therapy (CBT) group for women in the perinatal period for treatment of postpartum depression found that delivery via virtual format was effective based on results of decrease in Edinburgh Postnatal Depression Scale (EPDS) pre‐ and post‐intervention (Latendresse et al., 2021 ).…”

Experiences with Technology and Telehealth Among Women with Perinatal Depression

“…In 2012 the Institute of Medicine (23) addressed the need to evaluate the effectiveness of telehealth and urged researchers and funding bodies to follow the recommendations (24) to include "the use of more naturalistic methods and settings," and "better standardization of populations, interventions, and outcome measures." To address this issue, we evaluated a group videoconference intervention (VCI) to deliver mental health services to women with mild to moderate PD symptoms (25). The purpose of our subsequent qualitative study was to obtain the perspectives of the women who participated in these groups.…”