- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00745537
T- BOOM Teens--Building Options and Opportunities for Moms (T-BOOM)
Teens--Building Options and Opportunities for Moms
Postpartum depression (PPD) is depression that occurs shortly after the mother delivers her baby. Mothers with postpartum depression may feel sad mood, low motivation or stress; some may have problems caring for their new baby. Successful depression treatment involves early screening and detection of postpartum depression and early access to treatment services.
The purpose of this study is to evaluate the effectiveness of a telephone-based depression screening and care management program for postpartum women. We will evaluate the: 1) how often (frequency) young mothers develop symptoms of depression 4 to 6 weeks after birth, 2) how quickly (timeliness) young mother receive treatment and how effective (adequacy) are the treatments for the symptoms of postpartum depression, 3) the effects of depression care support on young mothers' symptoms and their ability to function at 3, 6 and 12 months after entering the study, 4) visits to the pediatrician or nurse practitioner (preventive health services) during their baby's first year of life, and 5) cost and cost savings associated with depression care management.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Depression during the perinatal period is a major public health concern. Postpartum depression (PPD) causes personal and family suffering at a time when adaptation to parenthood is critical. Successful interventions for treating depression in medical settings have been framed by a chronic disease management model. The key ingredient to success is a dedicated care manager who provides education and support to patients, actively coordinates care, and thereby improves treatment outcomes for patients. Compared to interventions in medical office settings, telephone care management positioned at the level of the health plan offers a systematic and efficient mechanism for ongoing treatment support of women with PPD, particularly in a geographically dispersed population.
We propose to conduct a comprehensive project to improve treatment outcomes for depressed postpartum women through adaptation of the depression care management model used in primary care settings. The major components are: 1) depression screening in a population of postpartum adolescents, 2) depression education for all who screen positive, 3) a diagnostic interview to evaluate for depressive disorders in mothers who score above and below a defined threshold on the screening instrument, 4) telephone-based care management intervention, and 5) longitudinal evaluation across the first year post-birth for depression and maternal and child public health outcomes. Focus groups will precede the major study components. A focus group of adolescent mothers will inform the investigators about the barriers to depression care management that encompass resource needs, acceptability of interventions to cope with stress or depression, and access to care. A separate focus group of community professionals of representatives from agencies or groups that provide community supports and health services will be used to explore the perceptions of barriers to care for new adolescent mothers. All participants in this project will be eligible for mental health services through their health plans that serve Medicaid and commercial members.
We plan to identify 125 child or adolescent new mothers with PPD. The child or adolescent new mothers will be assigned to depression care management. They will be supported in making choices about depression treatment (after receiving education about options), encouraged to access their preferred treatment (through the direct discussion of barriers and solutions), counseled to comply with treatment recommendations, and assisted to problem-solve if failure to respond occurs. All participants will have systematic evaluations at 3, 6, and 12 months post-birth. Outcomes include not only maternal depressive symptom levels but also functional and public health outcomes for mothers, families, and infants. We have developed a multi-disciplinary team with expertise in clinical research with depressed and minority women and health services to address these needs.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adolescent mothers age < 17 years 364 days at birth of index infant
- Live born infants
- Parents/guardian of the young mother must be available and competent to provide consent to the enrollment of the young mother
- The young mother may provide assent for her own enrollment.
- Ethical need for awareness of the possible risks, benefits and alternatives to enrollment in this study.
- Mothers with an EPDS>/=10 or CES-D>/=16 (suggest increased risk for major depression)
- Mothers with major depressive disorder (MDD) regardless of their EPDS or CES-D scores. These are patients with high risk for severe recurrence of depressive symptoms in the postpartum. We will assess their outcomes in this study.
- Adolescent mothers with an EPDS<10 OR CES-D<16 (screen negative) without MDD will be interviewed by phone with the KIDDIE-SADS mood screen to screen for all categories of major diagnoses AND the Mood Disorders Module
Exclusion Criteria:
- No access to a telephone Screening and depression care management are accomplished by phone; mothers with no phone are referred to Magee social work for other services
- NON-English-speaking Measures are in English
- The multiple questionnaires and measures are in English
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Adolescent Mother
aged less than 17 years old and recently gave birth
|
The adolescent mothers will be assigned a depression care management who will support the mother in making choices about depression treatment, educate about treatment options, discuss barriers and solutions, counsel to comply with treatment recommendations, and assisted to problem-solve if failure to respond occurs.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Severity of PPD will be assessed with the Children's Depression Rating Scale (CDRS).
Time Frame: Trained interviewers will complete the CDRS at baseline, 3, 6, and 12 months postpartum.
|
Trained interviewers will complete the CDRS at baseline, 3, 6, and 12 months postpartum.
|
Edinburgh Postnatal Depression Scale
Time Frame: Baseline, 3, 6, and 12 months
|
Baseline, 3, 6, and 12 months
|
Center for Epidemiologic Studies of Depression instrument (CES-D)
Time Frame: Baseline, 3, 6 and 12 months
|
Baseline, 3, 6 and 12 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
A specific measure of functioning at school or work and with peers, the Children's Global Assessment of Functioning (C-GAS) will be obtained.
Time Frame: baseline, 3, 6, and 12 months
|
baseline, 3, 6, and 12 months
|
The Social Function-12 (SF-12; Ware et al., 1993) is the most widely used measure of health-related functioning.
Time Frame: baseline, 3, 6, 12 months
|
baseline, 3, 6, 12 months
|
The Inventory of Functional Status after Birth (IFSAC) was used in studies of postpartum women to measure the woman's readiness to assume infant care and resume usual activities (Fawcett et al., 1988).
Time Frame: baseline, 3, 6 and 12 months
|
baseline, 3, 6 and 12 months
|
To assess the mother-infant relational quality, the Gratification in the Maternal Role (GRAT) is a 14-item checklist in which women rate each item on a 5 point scale (Mercer, 1985).
Time Frame: Baseline, 3, 6 and 12months
|
Baseline, 3, 6 and 12months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Katherine L Wisner, M.D., 3811 O'Hara Street, Oxford 410, Pittsburgh, PA 15123
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- B7473
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Postpartum Major Depression
-
Rhode Island HospitalNational Institute of Mental Health (NIMH); The Depressive and Bipolar Disorder...CompletedDepression | Postpartum Depression | Major Depressive DisorderUnited States
-
Yale UniversityWithdrawnPostpartum Depression | Major Depressive DisorderUnited States
-
Vibe G Frøkjær, MD, PhDHvidovre University Hospital; Herlev HospitalRecruiting
-
University of ZurichAmbulatorium für kognitive Verhaltenstherapie und Verhaltensmedizin - UZH; Lamprecht...Not yet recruitingPostpartum Depression | Major Depressive Disorder | Generalized Anxiety | Prenatal AnxietySwitzerland
-
Washington University School of MedicineNational Institute of Mental Health (NIMH)CompletedPostpartum Depression | Depressive Disorder, MajorUnited States
-
Gitte Moos KnudsenCenter for Integrated Molecular Brain Imaging, Copenhagen, Denmak; Fertility... and other collaboratorsCompletedSchizophrenia | Postpartum Depression | Menopause | Major Depressive Disorder | Neurodegeneration | Postpartum PsychosisDenmark
-
Johns Hopkins UniversityUniversity of VirginiaRecruitingPostpartum Depression | Bipolar Disorder | Major Depressive Disorder | Postpartum PsychosisUnited States
-
Women's College HospitalSunnybrook Health Sciences Centre; Centre for Addiction and Mental HealthRecruitingPostpartum Depression | Pregnancy | Major DepressionCanada
-
NeuroneticsTerminatedDepression, PostpartumUnited States
-
Pontificia Universidad Catolica de ChileAgencia Nacional de Investigación y Desarrollo, ANID; Instituto Milenio para...Not yet recruitingPost Partum Depression | Major Depressive Disorder | Minor Depressive Disorder
Clinical Trials on repeated mood measures and phone depression care management
-
University of TorontoKaiser Permanente; University of Colorado, BoulderCompletedDepressive Symptoms | Major Depressive Disorder, Recurrent, in RemissionUnited States
-
Weill Medical College of Cornell UniversityNational Institute of Mental Health (NIMH); University of Pennsylvania; University... and other collaboratorsCompletedDepression | Suicide, AttemptedUnited States
-
University of NottinghamNational Institute for Health Research, United KingdomUnknownChronic Unipolar Depressive DisorderUnited Kingdom
-
Weill Medical College of Cornell UniversityNational Institute of Mental Health (NIMH)Completed
-
University of Southern CaliforniaLos Angeles County Department of Public HealthCompletedBehavioral Symptoms | Depressive Disorder | Depression | Mood DisordersUnited States
-
University of Southern CaliforniaNational Institute of Mental Health (NIMH)Completed
-
Clinical Directors NetworkCompletedDepression | Cervical Cancer Screening | Breast Cancer Screening | Colorectal Cancer ScreeningUnited States
-
University of WashingtonNational Institute of Mental Health (NIMH)Completed
-
University of Texas Southwestern Medical CenterNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)CompletedType 2 Diabetes | Major Depressive DisorderUnited States
-
Duke UniversityNational Institute of Mental Health (NIMH); University of Alabama at Birmingham and other collaboratorsCompletedDepression | HIVUnited States