Internet-based behavioral activation—Treatment for postnatal depression (Netmums): A randomized controlled trial
Abstract
Background Despite the high prevalence of postnatal depression (PND), few women seek help. The internet may increase timely access to treatment. We report a randomized controlled trial of a minimal intervention internet Behavioral Activation (iBA) treatment modified to address postnatal specific concerns (Postnatal-iBA).Methods Women (n=910) recruited via a popular UK parenting site, Netmums.com, scoring above 12 on the Edinburgh Postnatal Depression Scale (EPDS) were randomly assigned to receive either Postnatal-iBA delivered or treatment-as-usual (TAU). We investigated the feasibility (recruitment, trial and treatment adherence) and effectiveness (depression status EPDS >12) of the intervention.Results Recruitment was excellent; 1261 women, 961 of whom met inclusion criteria, signed up to the trial within two 2-week recruitment periods. Thirty-eight percent (343/910) of women completed the 15-week outcome assessment. Of those who completed 15-week assessment, fewer exceeded the depression cutoff in the Postnatal-iBA group (n=66/181) compared to TAU (n=91/162). Assuming all non-respondents remained depressed, the Postnatal-iBA effect was reduced.Limitations The study suffered from high attrition and future trials need to consider strategies for improving outcome completion. Some women reported struggles "keeping up" with the treatment.Conclusions A minimal support, widely accessible internet Behavioral Activation program for PND is feasible to deliver to community populations when embedded within popular parenting sites. For women who provide outcome data, postnatal-iBA offers promise as an effective treatment for PND. The addition of support may reduce women's struggles to keep pace with the treatment.
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Other studies have reported substantial dropout rates between the first and the second module.
“Consistent with this, other studies have also reported substantial dropout rates between the first and the second module (O'Mahen et al., 2013).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as O'Mahen et al., 2013
For two studies the acceptance was unclear.
“for a further two studies the acceptance was unclear [53, 63]”
From Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review (2023) · cites this paper as [63]
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Self-citation
- Authors
- O'Mahen, H. A., Woodford, J., McGinley, J., Warren, F. C., Richards, D. A., Lynch, T. R., & Taylor, R. S.
- Affiliations
- University of Exeter (GB)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 150
- Issue
- 3
- Pages
- 814-822
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2082437209
- Cited by
- 202
- References
- 56
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 28 · 2023: 30 · 2022: 19 · 2021: 18 · 2020: 12 · 2019: 12 · 2018: 20 · 2017: 11 · 2016: 10 · 2015: 10 · 2014: 11 · 2013: 2
- FWCI
- 11.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0611-10203)
- Mashhad University of Medical Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- postpartum depression, online psychological intervention, parenting websites, medication adherence, attrition, Edinburgh Postnatal Depression Scale, maternal mental health
- MeSH terms
- Adult, Behavior Therapy, Female, Humans, Treatment Outcome, Depression, Postpartum, Internet
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