Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT) Full Trial
Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT): Intervening Early to Improve Maternal and Family Well-being.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
One of the main reasons that women do not receive treatment is that their mood and anxiety problems are not detected. Despite recommendations and high rates of acceptance by providers and women, only a minority of providers conduct psychosocial assessments as part of routine prenatal care. Computer-based 'screening' is an acceptable and feasible approach to assessment of sensitive issues including prenatal and postnatal intimate partner violence, mental health problems, and postpartum depression by patients and providers. It is well-suited for busy clinical settings and is advantageous in that it offers a consistent approach to assessment, is resource-sparing, can be tailored to meet the specific needs of patients, can be used with audio/video for low literacy, provides a real-time summary for patients/providers,achieves similar or higher rates of disclosure of violence and mental health problems, and is preferred by patients because they perceive it as more anonymous compared to interviews or questionnaires.
However, psychosocial assessment on its own is ineffective in preventing or treating mood disorders and unethical in the absence of treatment options. As such, many providers do not assess pregnant women for mood disorders because non-pharmacological treatments are frequently unavailable and pregnant women prefer them. Cognitive behavioural therapy (CBT) is a highly effective, non-pharmacological treatment for depression and anxiety and is recommended by perinatal national Australian guidelines as a potentially effective EARLY intervention for reducing the risk of maternal-child outcomes.
Studietype
Inschrijving (Verwacht)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Alberta
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Stony Plain, Alberta, Canada, T7Z 2M7
- Westview Health Centre
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion criteria:
Pregnant women will be eligible for Phase 2 if they are:
- < 28 weeks gestation (to provide the opportunity to complete 6 modules and follow-up questionnaires prior to delivery)
- able to speak/read English; and (3) willing to complete email questionnaires
Exclusion Criteria:
- >28 weeks gestation
- unable to speak/read English
- unable to complete email questionnaires
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Screening and CBT
Screening and Cognitive Behavioral Therapy.
The intervention group will be screened and if they need criteria they will complete the 6, 30-minute online, interactive CBT modules over 6 weeks.
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Cognitive Behavioral Therapy- an effective, non-pharmacological treatment for depression and anxiety.
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Geen tussenkomst: Usual care
Usual prenatal care
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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The primary outcome of this study is the feasibility/acceptability of integrated psychosocial care and its components.
Tijdsspanne: 6 weeks post randomization
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Feasibility/acceptability of the intervention will be assessed through individual face-to-face or telephone-based semi-structured qualitative interviews of both clinic staff and women in the intervention group.
The field does not allow for all questions to be provided.
Sample question for clinic staff is 'What aspects made it easy/challenging to use the tablet for prenatal assessment as part of routine prenatal care?' Sample questions for intervention group participants: 1)How did you feel about answering these kinds of questions on a tablet?; 2)Please describe any concerns you had about answering these questions on a tablet; 3)How would you prefer the results to be shared with you
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6 weeks post randomization
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Maternal depression, anxiety, stress
Tijdsspanne: on recruitment, 6 weeks post randomization and 3 months postpartum
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Depression, Anxiety, and Stress Scale (DASS-21) Self-reported by mother on emailed questionnaire
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on recruitment, 6 weeks post randomization and 3 months postpartum
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Maternal coping
Tijdsspanne: on recruitment, 6 weeks post-randomization and 3 months postpartum
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The Brief Cope Self-reported by mother on emailed questionnaire
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on recruitment, 6 weeks post-randomization and 3 months postpartum
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Relationship Adjustment
Tijdsspanne: on recruitment, 6 weeks post-randomization and 3 months postpartum
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Scale: Dyadic Adjustment Scale, DAS-7 Self-reported by mother on emailed questionnaire
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on recruitment, 6 weeks post-randomization and 3 months postpartum
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Parenting Stress
Tijdsspanne: 3 months postpartum
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Parenting Stress Scale Self-reported by mother
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3 months postpartum
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Parenting competence
Tijdsspanne: 3 months postpartum
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Parenting Sense of Competence Scale Self-reported by mother on emailed questionnaire
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3 months postpartum
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Maternal-infant attachment
Tijdsspanne: 3 months postpartum
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Maternal Attachment Inventory (MAI) Self-reported by mother on emailed questionnaire
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3 months postpartum
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Trait anxiety
Tijdsspanne: on recruitment, 6 weeks postrandomization, 3 months postpartum
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State Trait Anxiety Inventory (STAI) Self-reported by mother on emailed questionnaire
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on recruitment, 6 weeks postrandomization, 3 months postpartum
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Dawn A Kingston, Ph.D, University Of Calgary
Publicaties en nuttige links
Algemene publicaties
- Bright KS, Stuart S, Mcneil DA, Murray L, Kingston DE. Feasibility and Acceptability of Internet-Based Interpersonal Psychotherapy for Stress, Anxiety, and Depression in Prenatal Women: Thematic Analysis. JMIR Form Res. 2022 Jun 10;6(6):e23879. doi: 10.2196/23879.
- Bright KS, Mughal MK, Wajid A, Lane-Smith M, Murray L, Roy N, Van Zanten SV, Mcneil DA, Stuart S, Kingston D. Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial. Trials. 2019 Dec 30;20(1):814. doi: 10.1186/s13063-019-3897-z.
- Kingston D, Austin MP, Hegadoren K, McDonald S, Lasiuk G, McDonald S, Heaman M, Biringer A, Sword W, Giallo R, Patel T, Lane-Smith M, van Zanten SV. Study protocol for a randomized, controlled, superiority trial comparing the clinical and cost- effectiveness of integrated online mental health assessment-referral-care in pregnancy to usual prenatal care on prenatal and postnatal mental health and infant health and development: the Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT). Trials. 2014 Mar 6;15:72. doi: 10.1186/1745-6215-15-72.
Studie record data
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Studie voltooiing (Verwacht)
Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 00036912
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