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Postpartum depression (PPD) is a significant public health issue as it is frequently experienced and has a multi-generational impact. PPD can deleteriously affect parenting behaviors, the parent-child relationship and and infant functioning. Parenting is a potentially modifiable factor in the impact of PPD on children. Evidence-based parent interventions have been shown to be effective with improving parenting and parent-child interaction but do not address the effects of depression on parenting. There are significant barriers to engagement of parenting interventions among mothers with PPD, such as family obligations, lack of transportation, and perceived insufficient time. To address barriers to participation in parenting groups that women with PPD experience, we adapted a validated parenting intervention for use with women with PPD symptoms through Facebook (FB). The purpose of the study is to present the intervention adaptation, feasibility and initial outcomes.
Methods
The Parents Interacting with Infants program is a parenting intervention that promotes the social and emotional development of infants by improving parent-child dyadic interactions. Adaptations include depression psycho-educational material and use of a FB platform with video vignettes, instructional materials, and practice exercises. The intervention is 8 sessions (included depression psychoeducation, infant sleep, eating, play, temperament, safety, laughing, and reading). Mothers are eligible if they screen positive for PPD symptoms during their 2-month pediatric well child visit. We conducted an initial group with 6 mothers to test the intervention and then conducted a small randomized controlled trial with the comparison condition being an in-person group. Outcome measures were assessed pre- and post-intervention and included maternal depression symptoms, parenting competence and mother-infant interactions. We also assessed attendance and satisfaction ratings.
Results
Twenty four participants (83% African American, 71% single) were randomized to the trial. Women in both groups were similar in demographics. Attendance at the in-person groups was low (5%), while online “attendance” was high, with 83% visiting at least half the sessions on FB. Linear regression analyses of change scores showed that the FB group significantly decreased depression symptoms and increased parenting competence as compared to the in-person group. The average satisfaction rating for the FB group was 4 on a 5-point Likert scale. Analyses for mother-infant interactions are being analyzed.
Conclusions
The findings show that a parenting intervention administered on FB can be feasible and has benefits for women with PPD symptoms. Implications for infant development are considered.