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Articles

Effectiveness of online psychological interventions to prevent perinatal depression in fathers or non-birthing partners: A systematic and meta-analysis of randomized controlled trials - Internet Interventions

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Article title: Effectiveness of online psychological interventions to prevent perinatal depression in fathers or non-birthing partners: A systematic and meta-analysis of randomized controlled trials

Authors: Paula De-Juan, Irene Gómez-Gómez, Carlos Barquero-Jiménez, Claire A. Wilson & Emma Motrico

Journal: Internet Interventions

Year of Publication: Under review

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Abstract:

Little is known about the effectiveness of online preventive interventions for paternal perinatal depression (PPD). This systematic review (SR) and meta-analysis (MA) of randomized control trials (RCTs) evaluated the effectiveness of online psychological interventions to prevent PPD in fathers and non-birthing partners. The PRISMA 2020 guidelines were followed. The search was conducted in eight electronic databases and other sources from inception to 12 May 2023. Risk of bias was assessed by using the Cochrane ROB 2.0 tool. The standardized mean difference (SMD) was computed using random-effect models. Heterogeneity between studies and publication bias were explored, and sensitivity analyses were performed. Seven RCTs were included in the SR and 6 were included in the MA, representing 1.042 fathers from five different countries. The pooled SMD was -0.258 [95% confidence interval -0.513 to -0.004; p < 0.047]. The heterogeneity was moderate (I2=51%) and nonsignificant (p=0.070). However, the reliability of this result was not confirmed by sensitivity analyses. Only two RCTs had an overall low risk of bias. In conclusion, online psychological interventions had a small preventive effect on PPD. Given that the quality of evidence was low, and no trials focused on non-birthing partners were found, more high-quality evidence is needed.

Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: an umbrella review and meta-analytic synthesis - Acta Obstetricia et Gynecologica Scandinavica

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Article title: Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: an umbrella review and meta-analytic synthesis

Authors: Alessia Caffieri, Irene Gómez-Gómez, Carlos Barquero-Jiménez, Paula De-Juan, Giorgia Margherita & Emma Motrico

Journal: Acta Obstetricia et Gynecologica Scandinavica

Year of Publication: Accepted

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Abstract:

The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID-19 pandemic was assessed by several systematic reviews and meta-analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID-19 pandemic. An umbrella review of systematic reviews and meta-analyses (SR&MA) was performed. Searches were conducted in electronic databases up to April 2023. SR&MA reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eligible MAs were included in the quantitative synthesis. A total of 25 SRs (198 primary studies) and 12 MAs (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n=55; 95% CI= 25% – 33%) and 26% (n=54; 95% CI= 23% – 30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n= 44; 95% CI= 26% – 37%; n= 16; 95% CI= 24% – 39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium-high quality of the studies was observed. One SR assessed strength-of-evidence, reporting very low strength. During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed.

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Congress

Salud, bienestar y podcast: El proyecto e-Perinatal, at the II Encuentro global del audio en español

This communication presented the innovative e-Perinatal app.

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Presentation title: Salud, bienestar y podcast: El proyecto e-Perinatal

Congress: II Encuentro global del audio en español

Location: Málaga, Spain

Dates: October 5-6, 2023

Organizers: QWERTY Podcast y Loyola University

Presenter: Noemí Morejón Llamas

Abstract:

The presentation showcased the innovative e-Perinatal project, emphasizing how podcasts are becoming a vital tool in disseminating information about health and well-being.

Effectiveness of preventive interventions for perinatal depression: A protocol of a Meta-analytic Research Domain, at the 18th European Congress of Psychology

This study introduces a Meta-analytic Research Domain (MARD) methodology to aggregate and regularly update randomized control trial data for preventive interventions in perinatal depression, aiming to provide a comprehensive overview and guide future research and intervention development in this field.

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Presentation title: Effectiveness of preventive interventions for perinatal depression: A protocol of a Meta-analytic Research Domain

Congress: 18th European Congress of Psychology

Location: Brighton, United Kingdom

Dates: July 3-6, 2023

Organizers: European Federation of Psychologists

Presenter: Rosalba Company-Córdoba, Irene Gómez-Gómez, Paula De-Juan, Alessia Caffieri, Carlos Barquero-Jiménez, Clara Miguel-Sanz, Pim Cuijpers & Emma Motrico

Abstract:

This study presents the methodology used to perform a Meta-analytic Research Domain (MARD) of preventive interventions for perinatal depression. A huge number of systematic reviews and meta-analyses of randomized control trials (RCTs) focus on preventive interventions for perinatal depression. However, the results are inconclusive, making an urgent need to step up to higher levels of evidence synthesis. The ’Meta-Analytic Research Domain’ (MARD) is a new methodology to aggregate RCT data of a whole field. A MARD is a living systematic review of a research domain that cannot be covered by one PICO. We use MARD design following the PRISMA guidelines. Searchers will be conducted in the following databases: Embase, PubMed, CINHAL and PsycINFO (via EBSCO), Scopus and OpenGrey. RCTs’ studies involving adolescent and adult women who are in the perinatal period will be included. Any type of intervention whose goal is to prevent the incidence of perinatal depression or reduce perinatal depression symptoms will be considered. The updating process will be done regularly in order to detect new available studies. This MARD will show a living updated version of the studies that include interventions to prevent perinatal depression in women. It is expected that the inherent bias of meta-analysis and MARD studies may appear. The major disadvantage of MARDs is that they require considerable resources and research time to build and maintain. The MARD methodology will give a broad overview and identify new research lines in the prevention of perinatal depression. Furthermore, it will facilitate the development of preventive interventions focused on pregnant and postpartum women. This study presents the first and unique MARD focused on the effectiveness of preventive interventions for perinatal depression.

Clinical Online psychological interventions to prevent perinatal depression in fathers or non-birthing partners: systematic review and meta-analysis of randomized controlled trials, at the 18th European Congress of Psychology

This systematic review and meta-analysis evaluated the effectiveness of online preventive interventions for non-birthing partners or fathers without mental disorders in reducing postpartum depressive symptoms, revealing a need for more targeted, low-bias RCTs specifically for fathers.

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Presentation title: Clinical Online psychological interventions to prevent perinatal depression in fathers or non-birthing partners: systematic review and meta-analysis of randomized controlled trials

Congress: 18th European Congress of Psychology

Location: Brighton, United Kingdom

Dates: July 3-6, 2023

Organizers: European Federation of Psychologists

Presenter: Paula de-Juan, Carlos Barquero-Jiménez, Irene Gómez-Gómez, Claire Wilson & Emma Motrico

Abstract:

Paternal Perinatal Depression (PPD) is estimated to have an average prevalence of 8% to 13% in fathers during the perinatal period and has a negative impact on fathers’ well-being, family functioning, and child development. The purpose of this systematic review and meta-analysis (SR/MA) was to evaluate the effectiveness of online preventive interventions in non-birthing partners or fathers without depression or other mental disorders. PRISMA-DTA 2020 guidelines were followed. The search for eligible articles was conducted in PubMed, MEDLINE, PubMed, CINAHL Complete, PsycINFO, Scopus and Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), clinicalTrials.gov, Australian New Zealand Clinical Trial Registry, Beacon 2.0 and Psychotherapy Randomized Controlled and Comparative Trials. Grey literature in Opengrey was explored and experts in the field were asked for trial references or published studies. Selected RCTs involved non-birthing partners during the perinatal period (up to 12 months after childbirth). The results were a decrease in postpartum depressive symptoms and/or the incidence of PPD. Using random-effect models, the standardized mean difference (SMD) was computed. Sensitivity analyses were performed. A total of 6 RCTs were included in the SR-MA, conformed by 1752 participants, from five different countries. The pooled SMD was -0.258 [95% confidence interval (CI) -0.513 to -0.004; p < 0.001]. Heterogeneity was moderate (I2=51%). Only two RCTs had an overall low risk of bias. There were no available psychological online interventions delivered only for fathers or non-birthing partners, all were partner inclusive and their effect was not significant. Further RCTs with low risk of bias and specific fathers’ interventions to prevent PPD are needed.

Stakeholders’ involvement in the co-design and development of e-Perinatal, a mHealth app to prevent perinatal mental health disorders in maternal health care: Study Protocol, at the European Implementation Event

This presentation focuses on co-designing and developing the e-Perinatal app, a personalized mHealth tool for psychological intervention in maternal healthcare, aimed at preventing perinatal mental health disorders, with iterative testing and real-world trials in Andalusian public health care services.

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Presentation title: Stakeholders’ involvement in the co-design and development of e-Perinatal, a mHealth app to prevent perinatal mental health disorders in maternal health care: Study Protocol

Congress: European Implementation Event

Location: Basel, Switzerland

Dates: June 8-9, 2023

Organizers: Swiss Implementation Science Network & European Implementation Collaborative

Contributor: Paula De-Juan, Rosalba Company-Córdoba, Stephanie Carretero-Gómez, Carlos Barquero-Jiménez & Emma Motrico

Abstract:

This study aims to co-design and develop, together with the involvement of the stakeholders, an innovative personalized mHealth app called e-Perinatal for psychological intervention to prevent perinatal mental health disorders (depression and anxiety) in maternal health care. This project is framed in a European funded project (ERC grant). The sector will be the usual maternal health care programme framed in the public primary health care centres in available in the public health care services of the Andalusian Region in Spain. We will employ an iterative mixed-methods design to co-design, produce, and test a prototype of the e-Perinatal app, according to stakeholders’ preferences. We will follow these three phases: 1) A prototype of the e-Perinatal app (beta version) will be designed with a healthcare software development company. 2) The prototype will be refined via a co-design process with 144 local stakeholders. 3) Usability testing will be undertaken with 8 pregnant/postpartum women and 8 fathers/partners from phase 2. Framework analysis and quantitative data from usability testing by simple descriptive statistics and tests of differences will examine qualitative data. We will co-design with stakeholders the ‘e-Perinatal app’, an innovative and personalized mHealth psychological intervention for universal prevention of maternal PMD, to be provided by health professionals to women and their partners for use throughout the entire perinatal period. We will test the feasibility and effectiveness of the ‘e-Perinatal app’ in two real-world trials in routine maternal health care practice for the prevention of perinatal mental health disorders.

Translation and cultural adaptation of the Antenatal Risk Questionnaire-Revised, Parental Antenatal Attachment Scale, Quality of Marriage Index, Coparenting Relationship Scale scales for use in Spanish fathers and mothers in the perinatal period., at the XVIII Congreso de Metodología de las Ciencias Sociales y de la Salud

Presentation in poster format derived from the work of the E-perinatal Psychometrics substudy in which the results derived from the process of adaptation and cultural translation of the questionnaires scales Antenatal Risk Questionnaire-Revised, Parental Antenatal Attachment Scale, Quality of Marriage Index, Coparenting Relationship Scale are presented.

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Poster title: Translation and cultural adaptation of the Antenatal Risk Questionnaire-Revised, Parental Antenatal Attachment Scale, Quality of Marriage Index, Coparenting Relationship Scale scales for use in Spanish fathers and mothers in the perinatal period.

Congress: XVIII Congreso de Metodología de las Ciencias Sociales y de la Salud

Location: Seville

Dates: 3-6 September 2024

Organizers: Asociación Española de Metodología de las Ciencias del Comportamiento (AEMCCO)

Presenter: Irene Gómez Gómez

Contributor: Francisco Javier Nieto Casado; Sergio Castellanos Luna, Rosalba Company Córdoba, Sara Domínguez-Salas, Carmen Rodríguez Domínguez, Paula de Juan, Emma Motrico.

Abstract:

Introduction: The perinatal period represents a phase of vulnerability for the mother and father. At this stage, a greater risk of suffering from depression and anxiety has been observed, making it necessary to explore factors associated with these problems, such as prenatal risk, the quality of the couple’s relationship, the shared parenting style and attachment. prenatal of the parents. However, the questionnaires developed to evaluate these constructs have been developed in Anglo-Saxon populations, with no Spanish versions existing. Objective: To translate and culturally adapt the Antenatal Risk Questionnaire-Revised (ANRQ-R), Parental Antenatal Attachment Scale (PAAS), Quality of Marriage Index (QMI), and Coparenting Relationship Scale (CRS) for use by mothers and Spanish parents in the perinatal period. Method: The reverse translation method was used following Beaton’s guidelines. The original questionnaires were translated into Spanish by two independent researchers. A third reviewer was responsible for the back translation. Finally, the original version and the version translated into English were compared. The translated and adapted versions into Spanish were reviewed by a committee of experts (n = 4), following the guidelines of Hambleton and Zeneski. Results: The translated and adapted versions into Spanish did not present any discrepancies during the back-translation process, except for items 2 (ANRQ-R), 4 (QMI) and 8 (CRS). After the evaluation process by the expert committee, 12 items (54%) of the ANRQ, 1 item (16.7%) of the QMI, 10 items (71.42%) of the CRS and 4 items (25%) of the PAAS received suggestions from improvement. Conclusions: The Spanish versions of the ANRQ-R, QMI, CRS and PAAS questionnaires were obtained for use in mothers and fathers in the perinatal period. In the future, the psychometric properties of the Spanish versions generated should be examined.

Stakeholders’ involvement in the co-design and development of e-Perinatal mHealth app to prevent perinatal mental health disorders in maternal health care: Study Protocol, at the Implementation Research Scientific Conference

This poster focuses on co-designing and developing the e-Perinatal app –a personalized mHealth solution for preventing perinatal mental health disorders– through iterative mixed-methods design and real-world trials.

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Poster title: Stakeholders’ involvement in the co-design and development of e-Perinatal mHealth app to prevent perinatal mental health disorders in maternal health care: Study Protocol

Congress: Implementation Research Scientific Conference

Location: Bilbao, Spain

Dates: June 12-14, 2023

Organizers: RICAPPS

Contributor: Paula De-Juan, Rosalba Company-Córdoba, Stephanie Carretero, Irene Gómez-Gómez, Carlos Barquero-Jiménez, Roberto Cruz-Cabrera & Emma Motrico

Abstract:

In the current context, mobile-health interventions (mHealth), developed and examined for use without the need for direct human support, can be an affordable way to provide universal primary prevention of perinatal mental disorders worldwide. This study aims to co-design and develop an innovative, multicomponent, and personalized mHealth app called e-Perinatal to prevent perinatal mental health disorders (depression and anxiety) in maternal health care for being implemented in two real-world trials, as normal routine practice. This project is frame in a European funded project (e-Perinatal ERC Starting Grant). It will be employed an iterative mixed-methods design to co-design, produce, and test a prototype of the e-Perinatal app, according to stakeholders’ preferences. We will follow these three phases: 1) A prototype of the e-Perinatal app (beta version) will be designed with a healthcare software development company. 2) The prototype will be refined via a co-design process, by focus groups, with 144 local stakeholders. 3) Usability testing will be undertaken with 8 pregnant/postpartum women and 8 fathers/partners from phase 2. Qualitative data will be examined by framework analysis and quantitative data from usability testing by simple descriptive statistics and tests of differences, both will be triangulated. The participants will be asked for feedback for both content (micro-intervention sessions and information provided) and design (what features they found most useful, preferences for phrasing, wording, graphics, colors, and type of badge tier system). The different profiles of stakeholders included by means of theoretical sampling will enhance the discourse variability and will represent different groups. The results derived from the co-design analyses, are expected to improve the feasibility of the prototype of the e-perinatal app, in the pilot randomized controlled trial.

Patient and Public Involvement for the Prevention of Perinatal Mental Health Health Disorders: A study protocol, at the Implementation Research Scientific Conference

The ‘e-Perinatal’ project focuses on establishing the effectiveness of universal preventive interventions for perinatal mental disorders through scientific evidence and patient/public involvement (PPI), aiming to integrate these interventions into routine healthcare practices and evaluate the impact of PPI on the research process and outcomes.

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Poster title: Patient and Public Involvement for the Prevention of Perinatal Mental Health Health Disorders: A study protocol

Congress: Implementation Research Scientific Conference

Location: Bilbao, Spain

Dates: June 12-14, 2023

Organizers: RICAPPS

Contributor: Roberto Cruz-Cabrera, Paula De-Juan, Noemí Morejón-Llamas, C. A. González del Pino, Claire Wilson & Emma Motrico

Abstract:

The ‘e-Perinatal’ project aims to generate scientific evidence to establish the effectiveness of universal preventive interventions for perinatal mental disorders and their implementation as normalized routine practice in health care services. Patient and public involvement (PPI) in research is imperative for analysis of the implementation from a range of perspectives and to ensure the implementation is tailored appropriately to the local sociocultural context. The study aims to design, develop, and evaluate PPI in the e-Perinatal project. PPI will be involved in the conduct, reporting, and dissemination plans of this research, following the first international guide for reporting PPI in health and social care research (GRIPP-2 long form), in accordance with the INVOLVE principles. The ‘toolkit’ for PPI in clinical trials, developed by Bagley et al. (2016), will be used to monitor, train and support involvement in the different phases of the research project. The research meetings and PPI decisions will be documented. A mixed method, an online survey, and semi-structured interviews, will be used to assess the impact on people (i.e., research team, patients, and health care professionals). Also, it will be assessed the impact of PPI on research (i.e., changes made in the intervention program, and effectiveness of the intervention). It is expected that PPI will keep this research relevant for patients and carers since their perspectives are being considered in the conduct, reporting, and dissemination plans. Furthermore, the usage of the GRIPP-2 checklist, as well as the impact assessments (i.e., on people and on research), will give insights into how PPI can enhance the effectiveness and implementation process of evidence-based interventions. To the best of our knowledge, the e-Perinatal study will be the first to evaluate the PPI for the effectiveness and implementation of perinatal mental health prevention programs in health care services.

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Conferences

Jornadas de Promoción de la Salud Mental Perinatal en la Atención al Embarazo, Parto y Puerperio en Andalucía - Seville (Spain)

A successful exploration into perinatal mental health, our conference held in Seville (Spain) from November 15th to 17th, 2023, brought together leading experts and professionals in the field. Click for more details about the conference.

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Jornadas de Promoción de la Salud Mental Perinatal en la Atención al Embarazo, Parto y Puerperio en Andalucía

Location: Seville (Spain)

Dates: November 15-17, 2023

The event, a collaborative effort by e-Perinatal, the Asociación Andaluza de Matronas, and Loyola University, was a key gathering for professionals in maternal mental health. It focused on promoting dialogue and sharing research in perinatal mental health, covering topics like risk factor identification, use of diagnostic tools, and the latest advances in maternal health. Highlights included addressing challenges like perinatal death and gender-based violence in pregnancy, and showcasing the e-Perinatal app, a new tool to support mothers. Emphasizing midwives’ roles, the event enhanced their skills and knowledge, contributing significantly to the advancement of perinatal mental health care.

For further information about this project, please visit the event website here

Seminario sobre Salud Mental Materna - Seville (Spain)

Hosted by Universidad Loyola on May 18th, this seminar, in collaboration with RISEUP-PPD and supported by an ERC project, featured four experts discussing the latest in maternal mental health.

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Seminario sobre Salud Mental Materna

Location: Seville (Spain)

Dates: May 18, 2023

In celebration of Maternal Mental Health Week, Loyola University, in collaboration with RISEUP-PPD and supported by an ERC project, organized a comprehensive seminar dedicated to advancing knowledge and practices in maternal mental health. The seminar featured a panel of four distinguished experts in the field, each bringing their unique perspectives and research findings to the table. The discussions delved into various aspects of maternal mental health, highlighting the latest advancements, and exploring innovative strategies for prevention and treatment. The event served as a crucial platform for professionals, researchers, and students to exchange ideas, learn from leading voices in the field, and contribute to the evolving discourse on maternal mental health care.

For further information about this project, please visit the event website here