Introduction:
Perinatal depression and anxiety impose significant costs on the U.S. healthcare system and lead to adverse health outcomes. While cognitive behavioral therapy (CBT) has been shown to be effective in treating these conditions, barriers to accessing CBT have limited its success among pregnant individuals. This study aimed to assess the impact of a CBT-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people.
Study Design:
The study employed a 2-arm randomized controlled trial (RCT) design, integrated into group prenatal care. One arm received the Creating Opportunities for Personal Empowerment program, which was CBT-based, while the other received health promotion content.
Setting/Participants:
The study included Black and Hispanic participants (n=299) receiving prenatal care between 2018 and 2022 in New York and Ohio who screened high on at least one of three mental health measures.
Intervention:
Participants were randomized into either the Creating Opportunities for Personal Empowerment program, which involved cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting, or a group receiving health promotion content.
Main Outcome Measures:
Outcomes were assessed using validated tools for anxiety, depression, and stress symptoms (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). Healthy lifestyle beliefs and behaviors were evaluated using the Healthy Lifestyle Beliefs and Behaviors Scales.
Results:
There were no statistically significant differences between the two groups in anxiety, depression, stress, healthy beliefs, and behaviors. However, both groups showed significant improvements over time. Anxiety, depression, and stress decreased significantly from baseline to the end of the intervention, while healthy beliefs and behaviors significantly increased.
Conclusions:
Both the CBT-based intervention and health promotion content embedded in group prenatal care, delivered by advanced practice nurses, led to improvements in mental health and healthy lifestyle beliefs and behaviors during a period when perinatal mood typically worsens.
