Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Kathleen M Baggett, Betsy Davis, Lisa B Sheeber, Robert T Ammerman, Elizabeth A Mosley, Katy Miller, Edward G Feil, Kathleen M Baggett, Betsy Davis, Lisa B Sheeber, Robert T Ammerman, Elizabeth A Mosley, Katy Miller, Edward G Feil

Abstract

Mothers in the United States (U.S.) who are of non-dominant culture and socioeconomically disadvantaged experience depression during postpartum at a rate 3 to 4 times higher than mothers in the general population, but these mothers are least likely to receive services for improving mood. Little research has focused on recruiting these mothers into clinical intervention trials. The purpose of this article is to report on a study that provided a unique context within which to view the differential success of three referral approaches (i.e., community agency staff referral, research staff referral, and maternal self-referral). It also enabled a preliminary examination of whether the different strategies yielded samples that differed with regard to risk factors for adverse maternal and child outcomes. The examination took place within a clinical trial of a mobile intervention for improving maternal mood and increasing parent practices that promote infant social communication development. The sample was recruited within the urban core of a large southern city in the U.S. and was comprised primarily of mothers of non-dominant culture, who were experiencing severe socioeconomic disadvantage. Results showed that mothers self-referred at more than 3.5 times the rate that they were referred by either community agency staff or research staff. Moreover, compared to women referred by research staff, women who self-referred and those who were referred by community gatekeepers were as likely to eventually consent to study participation and initiate the intervention. Results are discussed with regard to implications for optimizing referral into clinical intervention trials.

Keywords: clinical trials; maternal depression; mobile intervention; recruitment; referral.

Conflict of interest statement

Landry developed the Play and Learning Strategies intervention program. Baggett, Davis, Feil, and Landry are the developers of the InfantNet program, the original intervention platform on which the ePALS Mom and Baby Net program application is based.

Figures

Figure 1
Figure 1
Percentage of each referral group contribution to the total referred sample.
Figure 2
Figure 2
Success of referral to intervention engagement by referral strategy.
Figure 3
Figure 3
Boxplot of risk for agency, self-referral, and research staff approaches.

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Source: PubMed

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