Assessing potential added benefits of trauma-focused content to a guided low-intensity psychoeducational intervention for perinatal women: A propensity score-matched analysis of a nonrandomized trial

TL;DR

This study explores whether adding trauma-focused content to a digital mental health program for pregnant women in Peru improves outcomes like depression and resilience.

Contribution

The study introduces a trauma-focused enhancement to a low-intensity digital intervention and evaluates its potential added benefits using propensity score matching.

Findings

Intervention uptake was high, with 77% of women participating in all sessions.

Trauma-focused content showed slight advantages in reducing depression symptoms and improving multisystem resilience.

Intimate partner violence had strong negative effects on mental health and parenting outcomes.

Abstract

Brief, low-intensity interventions may hold untapped promise for bolstering maternal health in low-resource contexts. The current study used propensity score matching (PSM) to evaluate uptake and differential effectiveness of two low-intensity digital perinatal health (PH) support programs in Lima, Peru. Pregnant women (N = 251) were assigned to one of two conditions (PH vs. trauma-focused PH [TF-PH]) and received weekly psychoeducational content via WhatsApp from a lay paraprofessional for 5 weeks. Conditions were not randomly assigned; PSM was used to improve causal inference of the condition. Women were interviewed before participation (T1), immediately following treatment (T2) and at 3 (T3) and 12 months postpartum (T4). Intimate partner violence had strong negative effects on women’s mental health, multisystem resilience and parenting, and single mothers reported higher levels of depression and posttraumatic stress symptoms than did partnered women. Intervention uptake was high, with 77% of women participating in all sessions. There were no significant differences between treatment groups over time, but effect sizes indicated a slight advantage of the TF-PH condition in addressing depression symptoms (d
r = −0.29) and multisystem resilience (d
r = 0.39). Study findings suggest that brief interventions may be well-received and that trauma-focused supports may also confer additional benefits for addressing depression and resilience.

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