Abstract
This study assessed participant, facilitator, and program-level characteristics associated with intervention dosage among women receiving an evidence-based perinatal depression preventive intervention, Mothers and Babies (MB). We also explored how intervention dosage affected the use and maintenance of core skills taught in the six-session group-based intervention. We conducted a secondary analysis of data from a cluster-randomized controlled trial in which 679 women enrolled in home visiting (HV) programs received MB prenatally. High dose of intervention was defined as attendance at > 50% of MB sessions, while MB skill utilization was measured by asking participants to indicate at 12 and 24 weeks postpartum the extent to which they used 12 core MB skills taught during the intervention. Age and racial concordance between participant and facilitator were significantly associated with intervention dosage. Those receiving higher intervention dosage tended to be older (27.25 ± 5.96 vs. 24.99 ± 5.60, p < 0.01, OR = 1.068 [1.038–1.098]), and received MB from a facilitator with a self-identified race similar to their own (58% vs. 48%, p = 0.04, OR = 1.485 [1.014–2.176]). Primary language of participants was marginally associated with dosage. Participants receiving a higher dose of intervention tended to exhibit greater MB skill utilization, on average at 24 weeks postpartum. These results can be used to identify strategies to promote intervention engagement. They further suggest that greater intervention dosage leads to increased use of core intervention skills that can promote improvements in participants’ behaviors and thoughts.
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Funding
This study was funded by Patient-Centered Outcomes Research Institute (PCORI)* Comparing the Effectiveness of Clinicians and Paraprofessionals to Reduce Disparities in Perinatal Depression (AD-1507–31473). The views, statements, and opinions in this manuscript are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee. REDCap is supported at FSM by the Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board Office of Northwestern University STU00203761, and written informed consent was received by all study participants in the C-RCT, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Johnson, J.K., Diebold, A., Yeh, C. et al. Examining Participant Dosage and Skill Utilization Associated with Receipt of a Perinatal Depression Preventive Intervention. Prev Sci 23, 1241–1250 (2022). https://doi.org/10.1007/s11121-022-01395-z
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DOI: https://doi.org/10.1007/s11121-022-01395-z