Wednesday, April 2, 2025
4/2/2025
Preventing Perinatal Anxiety: Testing an Internet-delivered Intervention - Project Summary/Abstract Anxiety disorders affect more perinatal women than any other psychiatric condition, yet they often go untreated. Up to 10.5% of mothers experience clinically significant prenatal anxiety, and up to 16% of mothers experience postpartum anxiety. Left untreated, perinatal anxiety is associated with significant adverse health outcomes for both mothers and infants, such as preterm birth, impaired fetal development, low birthweight, difficulty breastfeeding, anxiety in children, and interference with parent-infant bonding. Many mothers face economic and geographic barriers that limit their access to mental health services. Mental health accessibility is a particular concern for mothers who live in underserved, rural areas of the United States. Thus, there is a critical need for accessible and efficacious interventions to decrease and prevent perinatal anxiety and related disorder symptoms. “Preventing Postpartum Onset Distress” (P-POD; developed by Dr. Steinman) is an Internet-based, self-guided program, designed for both mothers and their romantic partners, to reduce and prevent maternal perinatal anxiety and related symptoms. P-POD is rooted in cognitive-behavioral theory and addresses key postpartum anxiety risk factors including: prenatal anxiety, dysfunctional beliefs, negative interpretation biases, and low perceived partner support. The Internet-based format of P-POD increases access to care by allowing couples to participate in the privacy of their home. Findings from an open-trial pilot study demonstrate that P- POD is acceptable, feasible, usable, and successfully reduces postpartum anxiety risk factors. Our research team is now ready to build upon these promising findings with a larger-scale test of P-POD efficacy in women (N = 100) at risk for perinatal anxiety in West Virginia, a predominantly rural state. The goal of this study is to conduct an RCT to test the effects of P-POD compared to an anxiety education control intervention on risk factors for postpartum anxiety (Aim 1) and mothers’ anxiety symptoms, relationships with their partners, and relationships with their infants at 8 weeks postpartum (Aim 2). Aim 2 will also include qualitative interviews with a purposive subsample of mothers (tentatively n = 25 per condition, based on thematic saturation), to understand the effects of P-POD (compared to the control condition) on perinatal women’s lives and to gain insight into mechanisms underlying differences in quantitative scores. The hypotheses are that compared to an educational control intervention, 1) P-POD will reduce prenatal anxiety and other risk factors for postpartum anxiety during pregnancy, and 2) result in lower maternal anxiety symptoms and improved familial relationships during the postpartum period. The proposed project is in line with NICHD’s high priority research areas of improving the health of women during and after pregnancy, improving pregnancy outcomes, and reducing perinatal health disparities.
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