STePPS CRE Projects

The STePPS CRE e-Psychological Perinatal Support projects hold the potential to make a profound impact on maternal and paternal mental health, reshaping the landscape of perinatal care for generations to come. Here are some of our early projects.

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Project 1

Knowledge gain is a key aim of this CRE.

The first stream of work focuses on perinatal depression e-prevention and e-treatment programs for new and expectant mothers and includes programs currently pioneered within the STePPS team. In order to achieve this a number of projects are planned. In the first instance, the evidence synthesis process will determine how to best extend and deploy the existing MumMoodBooster program.

Systematic review/review to identify key evidence-based e-treatments for women with depression from preconception to the postnatal period within a stepped care model.

Network and other meta-analyses of postnatal depression interventions for mothers. Individual Patient Data meta-analysis will focus on the identification of predictors and moderators (e.g. socio-demographic, cultural, clinical and timing) of treatment outcome of digital interventions. Predictors and moderators for uptake and engagement will also be identified.

These activities will be driven by the Evidence Synthesis Group chaired by Pim Cuijpers. Group composition: Jeannette Milgrom, Alan Gemmill, Helen Skouteris, Pim Cuijpers, Bei Bei, Nick Titov, Cindy-Lee Dennis, Julie Borninkhof, Vivette Glover, Louise Howard, Anette Bauer, Jane Fisher, Yafit Hirshler. It will also be supported by the work of one or our Early Career Researcher Marketa Ciharova.

Project 2

Early Career Researchers.

Another important aim of the CRE is to build workforce capacity and promote future leaders. As such, Year 1 of the grant offered Early Career stipends. The successful applicants and their projects are:

Digital Psychological Treatment and Prevention of Perinatal Depression: An IPD Meta-analysis. This work will inform the evidence synthesis described in Project 1.

Abstract

In order to deliver sustainable and effective digital prevention and treatment of perinatal depression to all new and expectant mothers, and to prevent distress in their family units, it is necessary to identify what individual will benefit from which kind of e-health option (i.e., guided online, self-guided online, or blended). In the current project, I will conduct an individual patient data meta-analysis (IPDMA), which will focus on identification of predictors and moderators of treatment outcome of digital prevention for new and expectant mothers, for their family units, and of interventions for mothers already experiencing perinatal depression. From an existing database of RCTs investigating effectiveness of treatments for depression, updated every three months (Cuijpers & Karyotaki, 2020), I will select studies assessing the effectiveness of digital interventions for perinatal depression.

I will conduct systematic searches in bibliographic databases to identify studies focusing on digital prevention of perinatal depression, and on prevention of and interventions for mental disorders in the family unit of new and expectant mothers. Subsequently, I will contact the authors of the identified studies and request individual patient data (IPD). The data collected will involve socio-demographic (e.g., age), cultural (e.g., cultural background), clinical variables (e.g., symptom severity, anxiety and trauma), and information related to family units (e.g., child and partner outcomes). After data control and harmonization, both one- and two-stage IPDMA will be conducted, to identify predictors and moderators of treatment outcome. Special emphasis in the analyses will be placed on culturally diverse and indigenous communities.

STePPS CRE CI Prof. Pim Cuijpers

Supporting Fathers and Partners during a Traumatic Pregnancy and Childbirth: Towards holistic care.

Abstract

Fathers and partners are largely forgotten in obstetric services. Maternal and fetal complications occur in up to one-third of pregnancies. This research project aims to improve care for fathers and partners who experience a traumatic pregnancy or birth. This project hopes to co-create effective educational resources for healthcare professionals, including online e-mental health tools with diverse consumers and organisations such as Red Nose and PANDA. The goal is to develop Best Practice Principles to support clinicians in providing holistic care for families and influence national policy mandates.

STePPS CRE CI Prof. Helen Skouteris

For more information, click here.

Application of Digital Phenotyping for Predicting Peripartum Depression: an integrative approach.

Abstract

Digital phenotyping, which is the process of capturing and analysing data from individuals’ digital devices, can potentially support the prediction of peripartum depression. However, no synthesised knowledge exists on how to most optimally achieve this based on the factors with highest predictive value. This project will focus on the review of existing literature on digital phenotyping contributing to the prediction of peripartum depression. The two main aspects of the review include the identification of: (1) key digital phenotyping variables related to peripartum depression; and (2) the combination of digital phenotyping variables with self-report measures to form predictive algorithms for peripartum depression. Related ethical and practical considerations will also be discussed in the articles.

In addition, we will use a Swedish ongoing mobile application-based mother cohort (Mom2B, https://mom2b.se/) to explore the use of predictive algorithms identified in the review, including combination with self-report measures. Preliminary results and challenges will be discussed. Overall, this project will deepen our knowledge of the application of digital phenotyping for predicting peripartum depression and identify crucial predictive factors and challenges that can further inform the development of personalised e-interventions.

STePPS CRE CI Assistant Prof. Annette Bauer and Prof. Alkistis Skalkidou 

Project 3

This CRE will aim to increase our knowledge regarding not only for maternal e-treatments but for addressing difficulties experienced by infants.

Project 3 focuses on e-prevention and e-treatment programs to strengthen the mother-infant relationship, and includes programs currently pioneered within the STePPS team. In the first instance, the evidence synthesis process will determine how to best extend and deploy the existing e-HUGS program.

Systematic review/review to identify Evidence synthesis for identification of key evidence-based mother-infant relationship e-interventions.

The existing mother-baby e-intervention e-HUGS will be further developed based on the evidence synthesis and how to embed this into existing referral pathways as targeting infants are not currently part of routine care were treating maternal depression. This is despite the evidence of the developmental impact without early intervention.

Project 4

e-Interventions in a Stepped-care Model

This CRE will use e-interventions in a stepped-care model to widen the scope of treatments and preventions to include fathers, partners and singles, and address difficulties in couple relationships.

We are conducting a feasibility study of a new e-prevention program for couples in pregnancy, called e-Towards Parenthood. e-Towards parenthood is an online self-help program providing support for the emotional, social and psychological challenges commonly encountered by soon to be mothers and fathers as they make the transition into parenthood. A substantial number of parents have difficulty navigating this transition. Around 10% of pregnant women experience antenatal depression and one half of these women will go on to develop postnatal depression. In addition, a significant proportion of parents have been found to experience clinically significant levels of stress in their parenting role.

e-Towards Parenthood aims to help parents manage the complex demands of parenting and strengthen the relationship between partners and their baby. The program provides skills in coping, problem-solving, enhancing self-esteem, assertive communication, bonding with baby, and understanding baby’s cues. This interactive program uses humor, fun activities, and cartoons, which were found in two RCTs of a workbook version to reduce symptoms of depression postnatally and assist couples in communication in the parenting role.

This feasibility study will evaluate participants’ satisfaction with and usage of the program in an online format, as well as its usefulness in supporting adjustment to the arrival of a new baby.


Investigators: Professor Jeannette Milgrom, Dr Charlene Holt, Dr Alan Gemmill, Professor Kim Felmingham

This project is supported by the work of Student Researcher, Sarah Murphy.

Project manager: Anneka Richmond

Developing methods for engaging depressed men in e-treatments and implementing it in our DadBooster program.

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