Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care.

BMJ : British Medical Journal
C Jane MorrellJon Nicholl

Abstract

To evaluate benefits for postnatal women of two psychologically informed interventions by health visitors. Prospective cluster trial randomised by general practice, with 18 month follow-up. 101 general practices in Trent, England. 2749 women allocated to intervention, 1335 to control. Health visitors (n=89 63 clusters) were trained to identify depressive symptoms at six to eight weeks postnatally using the Edinburgh postnatal depression scale (EPDS) and clinical assessment and also trained in providing psychologically informed sessions based on cognitive behavioural or person centred principles for an hour a week for eight weeks. Health visitors in the control group (n=49 38 clusters) provided usual care. Score >or=12 on the Edinburgh postnatal depression scale at six months. Secondary outcomes were mean Edinburgh postnatal depression scale, clinical outcomes in routine evaluation-outcome measure (CORE-OM), state-trait anxiety inventory (STAI), SF-12, and parenting stress index short form (PSI-SF) scores at six, 12, 18 months. 4084 eligible women consented and 595 women had a six week EPDS score >or=12. Of these, 418 had EPDS scores available at six weeks and six months. At six months, 34% women (93/271) in the intervention gro...Continue Reading

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Methods Mentioned

BETA
cognitive behavioural therapy

Software Mentioned

RANDOM
Stata

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