Mother Matters: Pilot randomized wait-list controlled trial of an online therapist-facilitated discussion board and support group for postpartum depression symptoms.

Abstract

In a pilot randomized waitlist-controlled trial (Ontario, Canada), individuals aged ≥18 years with Edinburgh Postnatal Depression Scale (EPDS) scores greater than 9 and who self-identified as a mother to a child aged 0-12 months were randomized 1:1 to Mother Matters (intervention) or usual care (control), with an opportunity to receive the intervention after the study was complete. The primary outcome was protocol feasibility, evaluated through recruitment feasibility, intervention acceptability, and adherence to study follow-up measures. Secondarily, postintervention EPDS scores and remission rates (EPDS < 10) were compared between groups. Ninety-eight participants were randomized (n = 50 intervention; n = 48 control) and seventy-seven (78.6%) completed postintervention questionnaires. About 88% of the intervention group (n = 44) logged into Mother Matters. Almost all topics were rated highly for relevance, there was good group cohesion and good satisfaction with the intervention. Mean (SD) EPDS scores decreased from 14.5 (4.07) to 11.3 (4.54) in the intervention group and 15.0 (3.56) to 12.0 (4.79) among controls (adjusted mean difference [aMD] -0.58, 95% confidence interval [CI]: -2.68 to 1.52), with remission in 37.8% versus 25.0% for intervention group and controls, respectively (χ2 = 1.48; p = .224). Among those with EPDS ≥ 16, the aMD was -3.66 (95% CI: -6.65 to -0.67) with remission in 41.2% in the intervention group versus 10.0% among controls (χ2 = 4.50; p = .06). This study supports the pursuit of online, therapist-facilitated, discussion board support group strategies for PPD. A large-scale efficacy and cost-effectiveness evaluation of Mother Matters is warranted.