Results from an effectiveness-implementation evaluation of a postpartum depression prevention intervention delivered in home visiting programs
Abstract
Background Building on growing research examining lay health professionals delivering postpartum depression preventive interventions, we conducted a hybrid effectiveness-implementation Type 2 trial to examine implementation metrics and determine whether pregnant women receiving Mothers and Babies 1-on-1 delivered by lay home visitors exhibit greater reductions in depressive symptoms and perceived stress than women receiving usual home visiting.Methods 1229 (672 control, 557 intervention) pregnant women were enrolled, with intervention participants receiving Mothers and Babies 1-on-1 delivered by a lay home visitor and control participants receiving usual home visiting services. Baseline and six-month follow-up assessments measured client mental health outcomes, with management information system data collected to assess intervention dosage. Surveys were administered nine months post-training to agency managers as well as home visitors who delivered any intervention content.Results Intent-to-treat analyses indicated a significant reduction in perceived stress among intervention participants compared to controls, while as-treated analyses showed significant reductions in perceived stress and depressive symptoms. Although all study sites adopted the intervention, <50 % of eligible women received the intervention. Over two-thirds of home visitors made at least one fidelity-consistent adaptation, with client recruitment and retention in home visiting highlighted as challenges to delivery.Limitations Unmeasured historical events may have affected study outcomes and caution should be used generalizing to perinatal women from different racial/ethnic groups and home visiting models.Conclusion Mothers and Babies 1-on-1 delivered by lay home visitors leads to reductions in perceived stress and depressive symptoms, suggesting task shifting to non-mental health professionals is viable when appropriate training and supervision is provided.
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Intervention effects on depressive symptoms and perceived stress were detected primarily at three months postpartum, consistent with previous MB trials demonstrating effects three months or later in the postpartum period.
“Intervention effects on depressive symptoms and perceived stress were detected primarily at 3 months postpartum, consistent with previous MB trials demonstrating effects 3 months or later in the postpartum period (Le et al. 2015; Tandon et al. 2014, 2022).”
From Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial. (2025) · cites this paper as Tandon et al. 2022
In previous trials, MB delivered without personalized JIT content has been consistently shown to reduce depressive symptoms and perceived stress in perinatal individuals.
“In previous trials, MB delivered without personalized JIT content has been consistently shown to reduce depressive symptoms and perceived stress in perinatal individuals (O’Connor et al. 2019; Tandon et al. 2022).”
From Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial. (2025) · cites this paper as Tandon et al. 2022
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- Authors
- Tandon, S. D., McGown, M., Campbell, L., Smith, J. D., Yeh, C., & Brady, C.
- Affiliations
- Northwestern University (US)
- Access Community Health Network (US)
- Oregon Health & Science University (US)
- University of Utah (US)
- Rush University Medical Center (US)
- Corresponding author
- Tandon, S. Darius
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 315
- Pages
- 113-120
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4286449054
- Cited by
- 21
- References
- 46
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 2
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation (73664)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- postpartum depression prevention, home visits, task shifting, pregnant women, perceived stress, depressive symptoms, intervention fidelity, implementation fidelity, perinatal mental health
- MeSH terms
- Female, House Calls, Humans, Infant, Mothers, Postnatal Care, Pregnancy, Depression, Postpartum, Pregnant People, Pregnant Women
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