Using smartphone-based psychoeducation to reduce postnatal depression among first-time mothers: Randomized controlled trial

Ko Ling Chan, Wing Cheong Leung, Agnes Tiwari, Ka Lun Or, Patrick Ip

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Smartphone-based psychoeducation interventions may be a low-cost, user-friendly alternative to resource-consuming, face-to-face antenatal classes to educate expectant mothers. Objective: This study aimed to empirically examine whether such an intervention would lead to reduced postnatal depression, anxiety, or stress and result in a better health-related quality of life. Methods: A single-blind randomized controlled trial was conducted in Hong Kong. All first-time expectant mothers with less than 24 weeks of gestation remaining and attending the antenatal clinic at a public hospital were included. Participants were assigned to the intervention group or the control group by drawing lots. The lots, presented in sealed opaque envelopes, were randomly designated as “intervention” or “control” by stratified randomization. The intervention, a psychoeducational mobile app, was provided in addition to the treatment as usual (TAU) services from the hospital. Follow up with participants took place at 4 weeks postpartum. The primary outcome was the difference in the levels of antenatal and postnatal depression, assessed by the Edinburgh Postnatal Depression Scale (EPDS). The intention-to-treat approach was employed in the analyses. Results: The final sample was 660 expectant mothers (nintervention=330 and ncontrol=330). The mean difference in EPDS scores between the two groups was −0.65 (95% CI −1.29 to 0.00; P=.049) after adjusting for confounding factors. Associations were found between participation in the intervention and reduced depression, and attendance in TAU classes and increased stress levels. Conclusions: The smartphone-based intervention plus TAU services was effective in reducing postnatal depression at 4 weeks postpartum compared with a control condition of TAU only, making this a cost-effective alternative to TAU education for expectant mothers. Limitations of the study included the short postpartum period after which the follow-up assessment was conducted and the inclusion of first-time mothers rather than all mothers.

Original languageEnglish
Article numbere12794
JournalJMIR mHealth and uHealth
Volume7
Issue number5
DOIs
Publication statusPublished - 2019 May

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Postpartum Depression
Randomized Controlled Trials
Postpartum Period
Mobile Applications
Single-Blind Method
Costs and Cost Analysis
Public Hospitals
Hong Kong
Random Allocation
Anxiety
Quality of Life
Smartphone
Depression
Education
Pregnancy
Control Groups

All Science Journal Classification (ASJC) codes

  • Health Informatics

Cite this

Chan, Ko Ling ; Leung, Wing Cheong ; Tiwari, Agnes ; Or, Ka Lun ; Ip, Patrick. / Using smartphone-based psychoeducation to reduce postnatal depression among first-time mothers : Randomized controlled trial. In: JMIR mHealth and uHealth. 2019 ; Vol. 7, No. 5.
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abstract = "Background: Smartphone-based psychoeducation interventions may be a low-cost, user-friendly alternative to resource-consuming, face-to-face antenatal classes to educate expectant mothers. Objective: This study aimed to empirically examine whether such an intervention would lead to reduced postnatal depression, anxiety, or stress and result in a better health-related quality of life. Methods: A single-blind randomized controlled trial was conducted in Hong Kong. All first-time expectant mothers with less than 24 weeks of gestation remaining and attending the antenatal clinic at a public hospital were included. Participants were assigned to the intervention group or the control group by drawing lots. The lots, presented in sealed opaque envelopes, were randomly designated as “intervention” or “control” by stratified randomization. The intervention, a psychoeducational mobile app, was provided in addition to the treatment as usual (TAU) services from the hospital. Follow up with participants took place at 4 weeks postpartum. The primary outcome was the difference in the levels of antenatal and postnatal depression, assessed by the Edinburgh Postnatal Depression Scale (EPDS). The intention-to-treat approach was employed in the analyses. Results: The final sample was 660 expectant mothers (nintervention=330 and ncontrol=330). The mean difference in EPDS scores between the two groups was −0.65 (95{\%} CI −1.29 to 0.00; P=.049) after adjusting for confounding factors. Associations were found between participation in the intervention and reduced depression, and attendance in TAU classes and increased stress levels. Conclusions: The smartphone-based intervention plus TAU services was effective in reducing postnatal depression at 4 weeks postpartum compared with a control condition of TAU only, making this a cost-effective alternative to TAU education for expectant mothers. Limitations of the study included the short postpartum period after which the follow-up assessment was conducted and the inclusion of first-time mothers rather than all mothers.",
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Using smartphone-based psychoeducation to reduce postnatal depression among first-time mothers : Randomized controlled trial. / Chan, Ko Ling; Leung, Wing Cheong; Tiwari, Agnes; Or, Ka Lun; Ip, Patrick.

In: JMIR mHealth and uHealth, Vol. 7, No. 5, e12794, 05.2019.

Research output: Contribution to journalArticle

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