Browsing by Author "Stuart, Scott"

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    Internet-based Interpersonal Psychotherapy for Stress, Anxiety, and Depression in Prenatal Women: A Feasibility and Acceptability Study
    (2020-08-07) Bright, Katherine S; Kingston, Dawn E.; Macneil, Deborah A.; Stuart, Scott
    Psychological distress, defined as perceived stress, anxiety, and depression during pregnancy is common and if left untreated has considerable adverse outcomes for mothers and their infants. Interpersonal psychotherapy (IPT), traditionally delivered face-to-face, is a recommended treatment for prenatal psychological distress. Unfortunately, for many women, there are significant barriers to accessing and engaging in face-to-face IPT during their pregnancy such as few IPT therapists, long wait-times, costs associated with conventional treatment, stigma, and childcare issues. Delivering IPT online, over the internet, is one approach to overcome these barriers and facilitate access to treatment for pregnant women. The aim of this doctoral research project was to investigate the feasibility and acceptability of internet-based IPT (e-IPT) for prenatal stress, anxiety, and depression.Within this thesis is contained; a systematic review protocol (Chapter 2), a systematic review (Chapter 3), a study protocol (Chapter 4), a qualitative study that explored the feasibility and acceptability of e-IPT (Chapter 5), and a quantitative study that provided an overview of the demographic and mental health data of the women drawn to participate in an internet-based guided support/perinatal mental health study (Chapter 6). The systematic review investigated the feasibility, acceptability, and efficacy of IPT treatments for psychological distress in perinatal women. The empirical investigation evaluated the feasibility and acceptability of e-IPT for stress, anxiety, and depression in perinatal women when compared to routine prenatal care. To date, this is the first study to investigate e-IPT for prenatal stress, anxiety, and depression. In summary, the review, study, and interviews provide evidence for the efficacy of e-IPT for prenatal stress, anxiety, and depression. Delivery of IPT online has clinical value, overcomes access and engagement barriers, and has the potential to reach more prenatal women suffering from psychological distress.
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    Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial
    (2019-12-30) Bright, Katherine S; Mughal, Muhammad K; Wajid, Abdul; Lane-Smith, Marie; Murray, Lindsay; Roy, Nicola; Van Zanten, Sander V; Mcneil, Deborah A; Stuart, Scott; Kingston, Dawn
    Abstract Background Psychological distress, defined as depression, anxiety and perceived stress, during pregnancy is common, with 15–25% of women experiencing clinically significant levels of such distress. Despite the far-reaching impact of prenatal psychological distress on mothers and their children, and that women are receptive to screening, few providers routinely screen for prenatal psychological distress and less than one in five women will receive the mental health care that they require. There is a lack of certainty regarding the most effective treatments for prenatal psychological distress. No online interpersonal psychotherapy (IPT) trials have been conducted that focus on improving psychological distress in prenatal women. The purpose of this pilot randomized controlled trial is to evaluate the perspectives of pregnant women on the feasibility and acceptability of online IPT (e-IPT) delivered during pregnancy. Methods A pilot randomized controlled trial design with repeated measures will evaluate the feasibility and acceptability of e-IPT for pregnant women compared to routine prenatal care. Qualitative interviews with 15–30 individuals in the intervention group will provide further data on the feasibility and acceptability of the intervention. Assessment of feasibility will include the ease of accessing and completing the intervention. Women will also be asked about what barriers there were to starting and completing the e-IPT. Assessment of acceptability will inquire about the perception of women regarding the intervention and its various features. A sample size of 160 consenting pregnant women aged 18 years and older will be enrolled and randomized into the experimental (e-IPT) or control (routine care) condition. The secondary outcome measures include: depression, anxiety and stress symptoms; self-efficacy; self-mastery; self-esteem; relationship quality (spouse, immediate family members); coping; and resilience. All participants will complete the aforementioned measures at baseline during pregnancy (T1), 3 months postrandomization (T2), at 8 months of pregnancy (T3), and 3 months postpartum (T4). Discussion The results of this pilot randomized controlled trial will provide data on the feasibility and acceptability of the intervention and identify necessary adaptations. This study will allow for optimization of full trial processes and inform the evaluation strategy, including sample size calculations for the full randomized controlled trial. Trial registration ClinicalTrials.gov, NCT01901796. Registered on 18 December 2014.
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    Interpersonal psychotherapy for perinatal women: a systematic review and meta-analysis protocol
    (2019-10-29) Bright, Katherine S; Charrois, Elyse M; Mughal, Muhammad K; Wajid, Abdul; McNeil, Deborah; Stuart, Scott; Hayden, K. A; Kingston, Dawn
    Abstract Background Interpersonal psychotherapy (IPT) is an intervention that has established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of well-being. There is limited data regarding factors that moderate and mediate the effectiveness of IPT including the timing of the intervention or the mode of delivery of IPT intervention. The objective of this systematic review and meta-analysis is to evaluate the effectiveness, feasibility, and acceptability of IPT interventions to treat perinatal psychological distress and to summarize the evidence on predictors, mediators, and moderators of IPT. Methods We will include peer-reviewed studies that recruited perinatal women. The search strategy will involve the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO), and Scopus. Study inclusion criteria include (1) randomized controlled trials, quasi-experimental studies, and pre-post studies that evaluated the effectiveness of IPT; (2) qualitative studies that evaluated feasibility and acceptability of IPT; (3) study sample included and analyzed perinatal women; and (4) publication language was English. Using pilot-tested screening and data extraction forms, two reviewers will independently review studies in three steps: (1) abstract/title screening, (2) full-text screening of potentially accepted studies, and (3) data extraction of accepted studies. Disagreements will be resolved by a third reviewer. Studies will be aggregated for meta-synthesis and meta-analysis should the data allow for this. Two independent reviewers will grade methodological quality. Discussion Findings from this review will inform future development and implementation of IPT intervention research for perinatal women. Identifying key factors of successful IPT interventions will inform intervention design and adaptation of IPT interventions to increase the likelihood that perinatal women will engage in and benefit from IPT interventions. This review will also identify key considerations for increasing the effectiveness of IPT interventions during the perinatal period. Systematic review registration PROSPERO CRD42019114292