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Effectiveness and Implementation of a Personalized mHealth Intervention for the Universal Prevention of Maternal Perinatal Mental Disorders (ePerinatal-RCT)

2026년 5월 25일 업데이트: Emma Motrico, University of Seville

Universal Prevention of Maternal Perinatal Mental Disorders and Its Implementation as Normalized Routine Practice (e-Perinatal): A Cluster Randomized Hybrid Effectiveness-Implementation Trial

This study is part of the ERC-funded e-Perinatal project and represents a large-scale hybrid type 1 effectiveness-implementation cluster randomized controlled trial. The primary aim is to evaluate the effectiveness of a personalized and complex mobile health (mHealth) intervention (e-Perinatal) in the universal prevention of maternal perinatal depression and anxiety disorders. Secondary aims include evaluating the impact on paternal mental health and child development, as well as examining implementation outcomes in real-world primary healthcare settings.

연구 개요

상세 설명

This clinical trial evaluates the effectiveness and implementation of the e-Perinatal intervention, a personalized mobile health (mHealth) psychological program designed for the universal prevention of maternal perinatal depression and anxiety disorders. The study will be conducted as a two-arm, cluster-randomized, hybrid type 1 effectiveness-implementation trial in routine maternal care settings within primary healthcare centers.

Primary healthcare centers will be randomized to either the intervention or control arm. Participants will include pregnant women and their partners.

The primary objective is to evaluate the effectiveness of the e-Perinatal intervention in reducing the cumulative incidence of maternal perinatal depression and anxiety disorders, assessed via structured diagnostic interviews. Secondary objectives include assessing maternal and paternal mental health outcomes, child development outcomes, and identifying moderators and mediators of intervention effectiveness.

In addition, the study will evaluate implementation outcomes, including acceptability, feasibility, adoption, fidelity, and barriers and facilitators to implementation in real-world healthcare settings.

Participants in the intervention group will receive access to the e-Perinatal app alongside usual maternal care. The e-Perinatal app includes: 1) Digital micro-interventions focused on psychological, physical activity, and healthy lifestyle domains; 2) a personalized recommendation engine; 3) a social support section; 4) mental health monitoring; 5) an 'SOS' button for assistance; and 6) an appointment reminder tool. Participants in the control group will receive usual maternal care.

연구 유형

중재적

등록 (추정된)

3000

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

  • 이름: Emma Motrico, PhD Psychology
  • 전화번호: 0034636995778
  • 이메일: eperinatal@us.es

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

설명

Inclusion Criteria:

- Inclusion Criteria (Women)

Must receive an invitation to participate from a healthcare professional at one of the participating primary healthcare centers

Must be pregnant for at least 11 weeks at the time of enrollment

Must be at least 18 years old

Must have access to a mobile phone and internet connection

Must be able to read, write, and understand Spanish

Must have a personal email account

No diagnosis of depression or anxiety disorder at baseline Forma

- Inclusion Criteria (Partners or significant others)

Must receive an invitation to participate from a woman already enrolled in the study

Must be at least 18 years old

Must have access to a mobile phone and internet connection

Must be able to read, write, and understand Spanish

Must have a personal email account

Exclusion Criteria:

  • Exclusion Criteria (Women)

Current diagnosis of depression or anxiety disorder

Receiving psychological or pharmacological treatment for mental health or substance use conditions

- Exclusion criteria for partners (or significant others):

There are no exclusion criteria for partners

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 방지
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 개입 그룹

The e-Perinatal intervention is a personalized mobile health (mHealth) program that includes: 1) Digital micro-interventions focused on psychological, physical activity, and healthy lifestyle domains; 2) a personalized recommendation engine; 3) a social support section; 4) mental health monitoring; 5) an 'SOS' button for assistance; and 6) an appointment reminder tool. The intervention is delivered through a mobile application and is integrated into routine maternal care.

Participants will use the app from recruitment (pregnancy) until 12 months of postpartum.

활성 비교기: 대조군
Participants will receive standard maternal care as provided by the public healthcare system, including routine antenatal and postnatal visits and access to maternal education programs.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Cumulative incidence of maternal perinatal depression and anxiety disorders
기간: Baseline and 12 months postpartum
Assessment method: Composite Internacional Diagnosis Interview (CIDI), based on DSM-5 criteria
Baseline and 12 months postpartum

2차 결과 측정

결과 측정
측정값 설명
기간
Maternal depressive symptoms (mothers)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Changes in depressive symptoms. Assessment method: The Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report measure. Each item is scored from 0 to 3, with higher scores indicating more severe depressive symptoms.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Maternal anxiety symptoms (mothers)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Changes in anxiety symptoms. Assessment method: The General Anxiety Questionnaire (GAD-7), a 7-item self-report measure. Each item is scored from 0 to 3, with higher scores indicating more severe anxiety symptoms.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Paternal depressive symptoms (partner)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Changes in depressive symptoms. Assessment method: The Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report measure. Each item is scored from 0 to 3, with higher scores indicating more severe depressive symptoms.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Paternal anxiety symptoms (partner)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Changes in anxiety symptoms. Assessment method: The General Anxiety Questionnaire (GAD-7), a 7-item self-report measure. Each item is scored from 0 to 3, with higher scores indicating more severe anxiety symptoms.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Psychological well-being (mothers, partners)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum
Changes in subjective well-being. Assessment method: The Well-Being Index (WHO-5), a 5-item self-report measure. Each item is scored from 0 to 5, with higher scores indicating better subjective well-being.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks), 6 weeks postpartum, and 6, 12, and 18 months postpartum

기타 결과 측정

결과 측정
측정값 설명
기간
변화 구현을 위한 조직의 준비 상태
기간: 채용 전 측정
일반적인 진료에 대한 변화를 구현하기 위한 조직의 준비 상태입니다. 평가 방법: ORIC(Organizational Readiness Implementing Change), 12개 항목 자체 보고 척도. 각 항목은 1부터 5까지 점수가 매겨지며, 점수가 높을수록 변화 구현에 대한 준비가 더 높은 것을 나타냅니다.
채용 전 측정
PHC 특성
기간: 채용 전 측정
PHC가 위치한 인구 규모 및 PHC 전문가 수. 평가방법 : 연구팀이 개발한 설문지
채용 전 측정
App quality (mothers, partners)
기간: 12 months postpartum
Objective and subjective quality, and the perceived impact of the application. Assessment method: The User Version of the Mobile Application Rating Scale (u-MARS), a 26-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating better app quality.
12 months postpartum
Implementation process
기간: 12 months postpartum
App implementation process from the perspective of healthcare professionals involved in implementing complex interventions. Assessment method: The Normalization Measure Development Questionnaire (NoMAD), a 20-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating more effective implementation processes.
12 months postpartum
Barriers and facilitators
기간: 12 months postpartum
Identifies barriers and facilitators impacting the integration of the intervention into routine healthcare, drawing from the experiences of users and healthcare professionals. Assessment method: Semi-structured interviews following the Normalization Process Theory (NPT) framework
12 months postpartum
Reasons for dropout (mothers, partners)
기간: 12 months postpartum
Number and reasons (e.g., experienced miscarriage or stillbirth, lack of engagement with the app) for dropout among women and their partners. Assessment method: Records and semi structured interviews.
12 months postpartum
Antenatal and postnatal risks (mothers, partners)
기간: Baseline, 6 weeks postpartum
Measures both antenatal and postnatal risk factors. Assessment method: The Antenatal Risk Questionnaire (ANRQ-R), a 11-item self-report measure. Some items are scored from 1 to 5 and others are scored on categorical scale, with higher scores indicating greater risk.
Baseline, 6 weeks postpartum
Basic psychological needs (mothers, partners)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measures the satisfaction and frustration of basic psychological needs. Assessment method: The Basic Psychological Need Satisfaction and Frustration Scale - Short Form (BPNSFS), a 12-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating a higher need satisfaction (i.e., need satisfaction subscale) or a higher need frustration (i.e., need frustration subscale).
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Maternal post-traumatic stress symptoms (mothers)
기간: 6 weeks postpartum
Presence of post-traumatic stress symptoms after childbirth. Assessment method: City Birth Trauma Scale (City-BiTS), a 5-item self-report measure. A total of 4 items are scored from 0 to 3 and one item is scored from 0 to 1, with higher scores indicating greater severity of postnatal post-traumatic stress.
6 weeks postpartum
Maternal perceptions of childbirth (mothers)
기간: 6 weeks postpartum
Measure of the perceived quality of the childbirth experience. Assessment method: Childbirth Experience Questionnaire (CEQ-E), a 22-items self-report scale. A total of 19 items range from 1 to 4. A total of 2 items range from 0 to 10. Higher scores indicate a more positive experience of childbirth.
6 weeks postpartum
Maternal breastfeeding experience (mothers)
기간: 6 weeks postpartum; 6 months postpartum
Assessment method: Ad hoc instrument. The instrument assesses infant feeding practices (2 items) and maternal satisfaction with breastfeeding (1 item), yielding a score ranging from 0 to 100. Higher scores indicate greater satisfaction with breastfeeding.
6 weeks postpartum; 6 months postpartum
Maternal antenatal attachment (mothers)
기간: 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measures the level of maternal antenatal attachment to the baby. Assessment method: The Maternal Antenatal Attachment Scale (MAAS), a 19-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating stronger maternal antenatal attachment.
34-36 weeks of gestation (for participants enrolled before 31 weeks)
Paternal antenatal attachment (partners)
기간: 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measures the level of paternal antenatal attachment to the baby. Assessment method: The Paternal Antenatal Attachment Scale (PAAS), a 16-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating stronger paternal antenatal attachment.
34-36 weeks of gestation (for participants enrolled before 31 weeks)
Maternal postnatal attachment (mothers)
기간: 6 weeks postpartum
Measures the level of maternal postnatal attachment to the baby. Assessment method: The Maternal Postnatal Attachment Scale (MPAS), a 19-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating stronger maternal postnatal attachment.
6 weeks postpartum
Paternal postnatal attachment (fathers)
기간: 6 weeks postpartum
Measures the level of postnatal attachment to the baby in both mothers and fathers. Assessment method: The Paternal Postnatal Attachment Scale (PPAS), a 19-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating stronger paternal postnatal attachment.
6 weeks postpartum
Psychological flexibility (mothers, partner)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measure of psychological flexibility. Assessment method: Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT), a 10-item self-report scale. Each item is scored from 1 to 7, with higher scores indicating greater psychological flexibilityTime
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Partnership quality (mothers, partners)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measures the quality of the marital or partnership relationship. Assessment method: The Quality of Marriage Index (QMI), a 6-item self-report measure. Some items are scored from 1 to 7 and others from 1 to 10, with higher scores indicating better relationship quality.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Parental role perception (mothers)
기간: 6 months postpartum
Measures parents' perception of their competence in the parental role. Assessment method: The Parental Sense of Competence scale (PSOC), a 21-item self-report measure. Each item is scored from 1 to 6, with higher scores indicating a stronger sense of parental competence.
6 months postpartum
Coparenting dynamics (mothers, partners)
기간: 6 months postpartum
Measures the dynamics of coparenting relationships. Assessment method: The Coparenting Relationship Scale (CRS), a 14-item self-report measure. Each item is scored from 0 to 6, with higher scores indicating more positive coparenting dynamics.
6 months postpartum
Mediterranean diet adherence (mothers, partners)
기간: Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Measure of adherence to the mediterranean diet. Assessment method: Mediterranean Diet Adherence Screener (MEDAS), a 14-items self-report instrument. Each item score from 0 to 1. Higher scores indicate greater adherence to the mediterranean diet.
Baseline, 34-36 weeks of gestation (for participants enrolled before 31 weeks)
Maternal physical activity levels (mothers)
기간: Baseline, 6 months postpartum
Measures physical activity levels in pregnant women and mothers. Assessment method: The Pregnancy Physical Activity Questionnaire (PPAQ), a 33-item self-report measure. Each item is scored from 0 to 5, with higher scores indicating higher levels of physical activity.
Baseline, 6 months postpartum
Physical condition (mothers)
기간: Baseline, 6 months postpartum
Measures overall physical condition and the main components (i.e., cardiorespiratory fitness, muscular strength, speed-agility, and flexibility) in pregnant women and mothers. Assessment method: The International FItness Scale (IFIS), a 5-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating better physical condition.
Baseline, 6 months postpartum
Child temperament (mothers)
기간: 6 months postpartum
Measures various aspect of infant temperament. Assessment method: The Infant Behavior Questionnaire-Revised Short Form (IBQ-R SF), a 37-item self-report measure. Each item is scored from 1 to 7, with higher scores indicating a higher frequency of the specified temperament behavior.
6 months postpartum
Child development (mothers)
기간: 6 months postpartum

Measures of various domains of infant development. Assessment method: Ages & Stages Questionnaires (ASQ-3), a self-report measure. Each milestone question is answered using one of three frequency options, which are converted into point values:

  • Yes: 10 points (the child is performing the skill)
  • Sometimes: 5 points (the child is beginning to perform the skill or does it occasionally)
  • Not Yet: 0 points (the child does not yet perform the skill)
6 months postpartum
Life quality (mothers, partners)
기간: 12 months postpartum
Measures the overall quality of life. Assessment method: The European Quality of Life-5 Dimensions-5 Levels (EuroQol-5D-5L), a 5-item self-report measure. Each item is scored from 1 to 5, with higher scores indicating worse quality of life
12 months postpartum
Identity (mothers, partners)
기간: Baseline, 6 months postpartum
Measure of various domains of identity development. Assessment method: Dimensions of Identity Development Scale (DIDS)., a 25-items self-report measure. Each item is scored from 1 to 5, with higher scores indicating greater endorsement of the corresponding identity development dimension.
Baseline, 6 months postpartum
Economic data
기간: 12 months postpartum
Measures healthcare service utilization and sick leave days over the previous year among participating women. Assessment method: a post hoc semi-structured interview that collects information on emergency visits, hospital admissions, primary care visits (e.g., nurse, midwife, social worker), secondary care visits, and consultations with specialists.
12 months postpartum

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Emma Motrico, PhD, University of Seville

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 5월 30일

기본 완료 (추정된)

2027년 12월 30일

연구 완료 (추정된)

2028년 3월 30일

연구 등록 날짜

최초 제출

2026년 5월 6일

QC 기준을 충족하는 최초 제출

2026년 5월 25일

처음 게시됨 (실제)

2026년 5월 29일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 5월 29일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 5월 25일

마지막으로 확인됨

2026년 5월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • EP-WP3-2025
  • 101042139 (기타 식별자: European Research Council (ERC))

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