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Published on: January 12, 2018
Feasibility, Acceptability, and Exploratory Efficacy of Implementing an Intervention for Preventing Postpartum
Marika Toscano1, Amanda Rubano2, Sydney R Santos3
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York.
Purpose:
Pregnant individuals hospitalized for obstetric complications experience perinatal depression at rates nearly double those in the general population. ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) is a brief, evidence-based intervention grounded in interpersonal therapy principles. Although effective in outpatient settings for preventing postpartum depression, its use in inpatient antenatal settings is untested. The objective of this study was to assess the feasibility, participant acceptability, and preliminary efficacy of delivering ROSE to hospitalized antepartum patients using a mixed-methods experimental design.
Basic Procedures:
A single-center mixed-methods experimental study (randomized controlled trial with embedded qualitative data collection) was conducted from July 2021 to March 2022. Participants admitted for prolonged antenatal hospitalization were randomized 1:1 to ROSE (four antenatal sessions and one postpartum session) or treatment as usual. Quantitative outcomes included enrollment, intervention completion, and follow-up rates, as well as acceptability via the Client Satisfaction Questionnaire-8. Semi-structured interviews explored participant experiences and were thematically analyzed and integrated with quantitative results.
Main Findings:
Of 85 individuals screened, 45 were randomized (ROSE n = 23; control n = 22). Enrollment (77.6%), retention (87.5%), and follow-up (92.0%) exceeded a priori feasibility thresholds. High acceptability scores aligned with qualitative themes describing the intervention as a helpful distraction, source of emotional support, and tool for developing coping and communication strategies. Preliminary findings also suggested reduced depression severity in the ROSE group at 6 weeks postpartum.
Principal Conclusions:
ROSE is feasible, and patients find it to be acceptable for use during inpatient antenatal care. Mixed-methods findings support further testing in larger, implementation-focused studies. (Clinical trial identification number: NCT05225025, A Pilot Trial of the Reach Out, Stay Strong, Essentials for Mothers of Newborns (ROSE) Postpartum Depression Prevention Intervention in Pregnant Patients Admitted to Strong Hospital, https://clinicaltrials.gov/study/NCT05225025, approved February 2, 2022.).