Postpartum depressive symptoms are common among women following the birth of a child and adversely impact a mother’s ability to care for her child. Evidence-based parent-coaching programs have been developed to guide mothers with parenting but do not address the effects of depression on parenting, can be expensive to administer, and may not facilitate participation by women with depressive symptoms. This program sought to develop a parent-coaching program for women with postpartum depressive symptoms utilizing a social media format to enhance participation. We adapted and manualized a validated parent coaching intervention, Parents Interacting With Infants (PIWI), and infused it with depression psychoeducational material, based on the Prevention Intervention Project, an empirically validated cognitive intervention for families with parental depression. We embedded the program in a social media format by creating Facebook Secret User Groups and inviting women who screen positive for depressive symptoms at their child’s 2-month well visit to participate. The program consisted of 8 weekly topics covering common infant parenting topics. The program utilized video clips, slide presentations, and exercises designed to promote responsive mother-infant bonds. Participants were encouraged to post comments and receive feedback from staff and “friend” other participants to build social support.
This program addresses parenting knowledge and skills that young women with postpartum depressive symptoms may not possess. It provides content on common infant parenting topics but has been infused with depression psychoeducation that can help women to recognize their depressive symptoms, improve their parenting abilities, and manage their depression and stress. Compared to traditional in-person group programs, this program utilizes a social media format (Facebook) that many women find appealing as well as convenient. This social media format permits participation in a validated parent-coaching program by women who may struggle to engage and attend a program outside of the comfort of their homes. In addition, use of a social media format for this program permits women flexibility to participate at times they find most convenient, encourages participants to interact with each other to promote social support, and allows administrators to provide feedback and encouragement to participants similar to traditional programs.
The leadership of this program, Drs. James Guevara and Rhonda Boyd, are currently collaborating with a local community agency, Maternity Care Coalition, to develop and implement this program. This collaboration has the potential to strengthen the relevance of the program to real world agencies that might utilize it in the future. The program is currently undergoing field testing at primary care practices affiliated with The Children's Hospital of Philadelphia (CHOP). Following the field testing, the program will be disseminated to local and national behavioral health organizations and policymakers. The leadership of this program are members of Policylab at CHOP, which aims to achieve optimal child health and well-being by informing program and policy changes through interdisciplinary research. To accomplish this mission, Policylab will assist with dissemination of program results to a broad policy audience through evidence-to-action briefs, email blasts, twitter feeds, and website postings.
The costs of this program are markedly less than comparable in-person group parent-coaching programs. This is due to the fact that there are no costs for meeting space, meals, childcare, and transportation tokens or parking for participants to attend group meetings. The main costs associated with the program are for a dedicated staff person to administer the Facebook Secret User group, post weekly content, and review and respond to participant posts. In addition, the popularity of social media has grown and will provide a popular venue for participants to interact with the program. Evidence from a recent Pew Research Center Survey reported that 89% of young adults 18-29 years old regularly use social networking sites, with little difference in use by race/ethnicity or income. Therefore, the decreased expenses for this program and the growing popularity of social media enhance this program’s potential sustainability.
The program has been manualized in terms of its content and structure, which will permit replication at other sites. In addition, the program’s specific content, including video clips, slide presentations, and exercises have already been developed and can be disseminated to other organizations and community agencies via website downloads or email. The program was developed in a multicultural manner using focus groups and includes perspectives and pictures of women from different cultures, races, and ethnicities. This will permit the program to be implemented in settings different from the setting in urban Philadelphia where it was developed. The program has not been translated into other languages, however, which limits its use to English speaking populations. If successfully field tested, we hope to translate the program into other languages to enhance its replicability.
- Findings from the current program’s field testing are pending. Results from a previous study showed that the program was not feasible in traditional in-person group formats. Only 50% of sixty eligible women, who consented to participate, attended any of the group sessions, and only 10% attended all of the group sessions. However, those women that were randomized to attend the parenting sessions immediately reported greater parenting skills (Parenting Scale) than women who were randomized to a wait-list control group. Anecdotally, we found that most participants had smart phones or computer access to social media sites and used them regularly. This latter finding provided the impetus and motivation for the current program utilizing social media to implement parenting education. The current field testing will collect data on changes in maternal depressive symptoms, self-reported parenting competence, and a videotape objective measure of interactive parenting that can be used to demonstrate program effectiveness.