The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized...

Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial.

Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up.

A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015).

Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.