A randomized controlled trial was conducted to evaluate the efficacy of a cognitive-behavioral (CBT) intervention to prevent perinatal depression in high-risk Latinas. A sample of 217 participants, predominantly low-income Central American immigrants who met demographic and depression risk criteria, were randomized into usual care (UC; n = 105) or an 8-week CBT group intervention during pregnancy and 3 individual booster sessions during postpartum (n = 112). Participants completed measures assessing depressive symptoms (Center for Epidemiological Studies Depression Scale at baseline; Beck Depression Inventory, Second Edition [BDI-II]) and major depressive episodes (Mood Screener) at 5 time points throughout the perinatal period. Intent-to-treat analyses indicated that intervention participants had significantly lower depressive symptoms and fewer cases of moderate depression (BDI-II ≥ 20) at Time 2 than UC participants. These effects were stronger for women who fully participated in the intervention (≥ 4 classes). The cumulative incidence of major depressive episodes was not significantly different between the intervention (7.8%) and UC (9.6%) groups. A CBT intervention for low-income, high-risk Latinas reduced depressive symptoms during pregnancy but not during the postpartum period. Low levels of depressive symptoms and lower than expected rates of clinical depression in both groups may partially be due to methodological issues. As perinatal depression is a significant public health problem, more work is needed to prevent perinatal depression in low-income, ethnically diverse women.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Background: Postnatal depression adversely affects mothers and infants. There is evidence that caregiving difficulties associated with depressive symptoms also adversely affect later childhood development. In many countries, resources available to support mothers experiencing depressive symptoms during the postnatal period are limited. Cost-effective online group-based nurse-led interventions delivered by mobile phone ‘apps’ have the potential to help address this problem by providing large numbers of mothers with access to professional and peer support during the postnatal period. Objective: Objective: The aim of this study was to test the effectiveness of a 4-month online group-based nurse-led intervention delivered when infants were 2-6 months as compared to standard care outcomes. Methods: Methods: The study was a block randomised control trial. Mothers were recruited at the time they were contacted for the postnatal health check offered to all mothers in South Australia. Those who agreed to participate were randomly assigned to the intervention or standard care. The overall response rate was 63% (N=133/210). Primary outcomes were level of maternal depressive symptoms assessed with the Edinburgh Postnatal Depression Scale (EPDS); and quality of maternal caregiving assessed using the Parenting Stress Index (PSI competence and attachment subscales), the Parenting Sense of Competence Scale, and the Nursing Child Assessment Satellite Training Scale. Assessments were completed at baseline (mean child age=4.9 weeks, SD=1.4) and again when infants were aged 8, and 12 months. Results: Results: Outcomes were evaluated using linear generalized estimating equations adjusting for post-randomization group differences in demographic characteristics and the outcome score at baseline. There were no significant differences in the intervention and standard care groups in scores on the PSI competence subscale (P=.69) nor the Parenting Sense of Competence Scale (P=.11). While the group by time interaction suggested there were differences over time between the EPDS and PSI attachment subscales scores in the intervention and standard care groups (P=.001 and P=.04 respectively), these arose largely because the intervention group had stable scores over time while the standard care group showed some improvements between baseline to 12 months. Mothers engaged well with the intervention with 60% of mothers logging-in once per week during the first 11 weeks of the intervention. The majority of mothers also rated the intervention as helpful and user-friendly. Conclusions: Conclusions: Mothers reported that the intervention was helpful and the app was described as easy to use. As such, it appears that support for mothers during the postnatal period, provided using mobile phone technology, has the potential to be an important addition to existing services. Possible explanations for the lack of differences in outcomes for the two groups in this study are the failure of many mothers to use key components of the intervention and residual differences between the intervention and standard care groups post-randomization. Clinical Trial: Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN 12616001732471

Historically, much of the research on parenting has not disentangled the influences of race/ethnicity, SES, and culture on family functioning and the development of children and adolescents. This special issue addresses this gap by disentangling ethnic differences in parenting behaviors from their contextual influences, thereby deepening our understanding of parenting processes in diverse families. Six members of the Parenting Section of the Study Group on Race, Culture, and Ethnicity (SGRCE) introduce and implement a novel approach toward understanding this question. The goal of this project is to study culturally related processes and the degree to which they predict parenting. An iterative process was employed to delineate the main parenting constructs (warmth, psychological and behavioral control, monitoring, communication, and self-efficacy), cultural processes, and contextual influences, and to coordinate a data analytic plan utilizing individual datasets with diverse samples to answer the research questions.