Acceptability and Appropriateness of a Perinatal Depression Preventive Group Intervention: A Qualitative Analysis

Abstract

Background Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A current cluster-randomized controlled trial is examining the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs. Methods The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored. Results Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms. Conclusions Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals.

Mothers' and birthing parents' experiences with 1‐day cognitive behavioural therapy‐based workshops for postpartum depression: A descriptive qualitative study

“…Finding a community within the workshop group was seen as one of the most valuable aspects of the intervention, which is notable because it echoes previous studies on individuals' perceptions of the impact of peer support and open discussions (Grote et al., 2021; Jones et al., 2014; Masood et al., 2015; McLeish & Redshaw, 2017; O'Beney et al., 2019). Indeed, peer support can be particularly important in providing a safe environment for those with PPD to express themselves without fearing stigma and reducing isolation (Dennis & Chung‐Lee, 2006; Diebold et al., 2020; Scope et al., 2012; Westgate et al., 2023).…”