This is a parallel-group randomized controlled trial. A total of 198 postpartum women with depressive symptoms (EPDS scores≥8 at baseline) will be recruited and randomized into two groups: 10-week mindful yoga intervention and 10-week psychoeducation program. Clinical assessment of depression, self-report questionnaires and salivary cortisol tests will be performed at baseline, after 10-week intervention, and at 6-month and 12-month follow-ups. The investigators expected that the mindful yoga intervention will reduce depression after 10 weeks compared to psychoeducation. The mindful yoga intervention will further reduce anxiety, stress, improve quality of life and sleep, and steepen diurnal cortisol slopes. These effects will be maintained for at least six months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
198
The intervention includes mindfulness-based components and yoga practice. Once a week for 10 weeks, with 1.5 hours in each session (30 minutes mindfulness-based practice and 1 hour yoga practice). A well-trained research personnel will facilitate the mindfulness-based section, and a qualified yoga instructor will facilitate the yoga section.
Knowledge of perinatal mental health, stress-related management, postnatal nutrition, exercise habit and sleep hygiene will be provided to the participants in the psychoeducation group. It is a group-based intervention delivered in hybrid mode including face-to-face and online group-based class. Once a week for 10 weeks, with 1.5 hour in each session.
The Hong Kong Polytechnic University
Hong Kong, Hong Kong
Edinburgh Postnatal Depression Scale
Measures postnatal depression. Each item scores 0-3, and the total score ranges from 0 to 30. Higher score means worse depressive symptoms.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Depression Anxiety Stress Scale-Depression
Measures depressive symptoms. Each item scores 0-3, the total score for depression ranges from 0 to 21. Higher score means worse symptoms of depression.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Depression Anxiety Stress Scale-Anxiety
Measures anxiety symptoms. Each item scores 0-3, the total score for anxiety ranges from 0 to 21. Higher score means worse symptoms of anxiety.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Depression Anxiety Stress Scale-Stress
Measures stress symptoms. Each item scores 0-3, the total score for stress ranges from 0 to 21. Higher score means worse symptoms of stress.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Pittsburgh Sleep Quality Index
Measures sleep quality. There are 8 components scores, and each component score ranges from 0 to 3. Higher score means worse sleep quality.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
36 Item-Short Form Health Survey Questionnaire
Measures quality of life including physical and mental health. Each item scores 0-100. There are eight subscores ranging from 0 to 100. Higher score means better quality of life.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Five Facet Mindfulness Questionnaire
Measures the level of mindfulness ability. Each item scores 1-5, and the total score ranges from 42 to 210. Higher score means better mindfulness ability.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Pregnancy Symptom Inventory
Measures physical pain and fatigue of postpartum women. Each item scores 0-3. The total score ranges from 0 to 24. Higher score means worse pregnancy symptoms.
Time frame: Baseline, 10 weeks, 6 months and 1 year follow-ups.
Cortisol concentration level
Measures salivary cortisol concentration at baseline and post-intervention. Higher concentration means higher level of stress and depression.
Time frame: Baseline and 10 weeks (post-intervention).
Physical fitness
6-minute walking test is used for physical fitness measure. The total distance walked during 6 minutes is recorded. Higher score means better fitness.
Time frame: Baseline and 10 weeks (post-intervention).
Balance
Single-leg standing test is used to measure the balance. The time to keep the posture is recorded. Higher score means better balance ability.
Time frame: Baseline and 10 weeks (post-intervention).
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