The prevalence rate of maternal depression in Pakistani women and its effect on the growth and development of young children and child mortality is very high. The main objective of this study is to increase access to evidence based psychological interventions for mothers who have children of age 0 to 30 months, consistent with her values. The study will be a 2 (conditions) into 3 (Time) single blind randomized controlled trail. Depressed mothers will be randomized either to intervention arm or control arm. Intervention will include text messages based on Learning Through Play Plus (LTP plus CBT).
Disturbances in mother-infant relationship in depressed mothers negatively influence the child's development. There are a number of efficient treatments for postnatal depression including antidepressant medication, psychotherapy and psychosocial interventions. Tele-health and mobile health is a novel and emerging field in psychiatric and psychological care and treatment of mental health difficulties, it involves the use of telecommunications to provide health care, support and intervention from a distance. The proposed study will test the efficacy of an innovative, affordable mobile based intervention program that can help mothers with postnatal depression in low resource countries such as Pakistan. Participants will be recruited from maternal and child care centres in Karachi, Pakistan and those participants (n = 204) meeting inclusion criteria of the study will be randomized into one of the 2 treatment arms, i.e., intervention or control, after completion of baseline assessment. Intervention will be comprised of LTP Plus and will be delivered through text messages. Momentary Sampling assessment and Momentary Psychological intervention will be part of this study. Participants will be assessed again after completion of intervention (i.e., after 12 weeks) and then 3 months post intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
208
Learning through Play Plus Intervention delivered through mobile phone
Jinnah Hospital
Lahore, Punjab Province, Pakistan
Chiniot Maternity Hospital
Karachi, Sindh, Pakistan
Sobhraj Maternity hospital
Karachi, Sindh, Pakistan
Edinburgh Postnatal Depression Scale (EPDS)
EPDS will be used to screen depression in mothers with child 0-30 months.
Time frame: change in scores from baseline to 3rd month and 6th month
Patient Health Questionnaire (PHQ-9)
PHQ-9 will be used to assess the severity of depression
Time frame: change in scores from baseline to 3rd month and 6th month
EuroQoL-5 Dimensions (EQ-5D)
EQ-5D will be used to assess the health related quality of life
Time frame: change in scores from baseline to 3rd month and 6th month
Generalized Anxiety Disorder - 7 (GAD-7)
GAD 7 will be used to assess severity of anxiety.
Time frame: change in scores from baseline to 3rd month and 6th month
Knowledge of Expectation and Child Development
25-item questionnaire will be used to assess maternal knowledge and expectations for child development in the first three years. Higher scores indicate better outcomes.
Time frame: change in scores from baseline to 3rd month and 6th month
Clinical Interview Schedule Revised (CISR)
The clinical Interview Schedule-Revised is a structured diagnostic instrument that was developed from the Clinical Interview Schedule (CIS), to assess psychiatric problems
Time frame: Change in scores from baseline to 3rd month and 6th month
Assessment of the growth and development of children (Weight)
Anthropometric measures of child growth will be collected through measuring children's weight in kilograms. weight and height will be combined to report BMI in kg/m\^2
Time frame: Change in scores from Baseline and 6 month
Assessment of the growth and development of children (Height)
Anthropometric measures of child growth will be collected through measuring children height in meters. weight and height will be combined to report BMI in kg/m\^2
Time frame: Change in scores from Baseline and 6 month
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