MOMCare: Culturally Relevant Treatment Services for Perinatal Depression

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Nancy Grote, University of Washington
ClinicalTrials.gov Identifier:
NCT01045655
First received: January 8, 2010
Last updated: May 8, 2013
Last verified: May 2013

January 8, 2010
May 8, 2013
January 2010
January 2014   (final data collection date for primary outcome measure)
SCL-20 depression [ Time Frame: baseline, 3, 6 12, 18 month follow-ups ] [ Designated as safety issue: No ]
Number of depression treatment sessions attended, depression severity and diagnosis (PHQ-9 depression, SCL-20, Edinburgh Postnatal Depression Scale), and Social Functioning (Work & Social Adjustment, Social & Leisure, Social Support, IFSAC) [ Time Frame: screening, baseline, 3, 6 12, 18 month follow-ups ] [ Designated as safety issue: No ]
Complete list of historical versions of study NCT01045655 on ClinicalTrials.gov Archive Site
  • Maternal health services utilization use and estimated costs [ Time Frame: baseline, 3, 6 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Pregnancy, delivery, birth outcomes [ Time Frame: 6 month follow-up ] [ Designated as safety issue: No ]
  • Child services & outcomes (immunizations, well-child visits) [ Time Frame: 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Depression free days & Quality Adjusted Life Years (EuroQol) [ Time Frame: 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Quality of depression care process [ Time Frame: 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Number of depression treatment sessions attended [ Time Frame: 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • PHQ-9 depression [ Time Frame: screening, baseline, 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Edinburgh Postnatal Depression Scale [ Time Frame: baseline, 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Social Functioning (Work & Social Adjustment, Social & Leisure, Social Support) [ Time Frame: baseline, 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Inventory of Functional Status After Childbirth (IFSAC) [ Time Frame: 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Maternal health services utilization use and estimated costs [ Time Frame: baseline, 3, 6 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Pregnancy, delivery, birth outcomes [ Time Frame: 6 month follow-up ] [ Designated as safety issue: No ]
  • Child services & outcomes (immunizations, well-child visits) [ Time Frame: 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Depression free days & Quality Adjusted Life Years (EuroQol) [ Time Frame: 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
  • Quality of depression care process [ Time Frame: 3, 6, 12, 18 month follow-ups ] [ Designated as safety issue: No ]
Not Provided
Not Provided
 
MOMCare: Culturally Relevant Treatment Services for Perinatal Depression
For Moms: Culturally Relevant Treatment Services for Perinatal Depression

The study will evaluate the effectiveness of a culturally relevant, multi-component intervention for antenatal depression. The intervention includes an engagement session, and the woman's choice of brief interpersonal psychotherapy and/or pharmacotherapy in a stepped care treatment for depression model.

The randomized control trial will evaluate the effects of a culturally relevant, multi-component intervention for antenatal depression. MOMCare has the potential to overcome patient, provider, and system-level barriers to care and engage depressed, low-income women in evidence-based treatments to reduce antenatal depressive symptoms, improve maternal psychosocial functioning, and ameliorate postpartum depression. Specific Aim 1: To evaluate the impact of MOMCare on treatment engagement and retention. Specific Aim 2: To evaluate the impact of MOMCare on maternal clinical symptoms and functional outcomes. Specific Aim 3: To conduct an incremental cost-effectiveness analysis for a health care and welfare agency perspective that includes a) tracking the medical costs of health service use in MOMCare and usual care patients; b) monitoring the use of infant preventative health services in both groups; and c) tracking the percentage of women on Medicaid and the percentage working in both groups.

The intervention will be assessed through a practical randomized controlled trial in which we have recruited 168 pregnant women with major depression and/or dysthymia who were on Medicaid and/or received Maternal Support Services (MSS) in selected public health centers in Seattle - King County (PHSKC). Patients who were eligible and consented to study enrollment were randomly assigned to either usual care (UC) or MOMCare. Baseline and four follow-up assessments (3 - 18 months post-baseline) are scheduled for study participants in both groups. The MOMCare intervention includes a choice of brief interpersonal psychotherapy or collaborative management of antidepressant medication. Treatment response will be monitored, and the treatment will be adjusted as necessary (adding treatments, increasing dosages).

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Depression
Behavioral: MOMCare
8 sessions of brief interpersonal psychotherapy or medication management; maintenance sessions through 12 months postpartum.
  • Experimental: MOMCare intervention
    Depression care treatment with study depression care specialist (brief interpersonal psychotherapy or pharmacotherapy)
    Intervention: Behavioral: MOMCare
  • No Intervention: Care Plus
    Usual care group; referral to community mental health treatment
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
168
January 2014
January 2014   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • 18 or older
  • pregnant: 12-32 weeks gestation
  • able to speak English
  • telephone access
  • major depressive disorder or dysthymia
  • on Medicaid
  • receiving health care in King County, Washington

Exclusion Criteria:

  • currently in psychotherapy
  • currently receiving pharmacotherapy from a psychiatrist
  • high suicide risk
  • history of bipolar disorder
  • history of schizophrenia
  • substance use or dependence in previous 3 months
  • currently in a relationship with severe interpersonal violence
  • history of repetitive self-harm behavior
Female
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01045655
R01 MH084897, R01MH084897, R01 MH084897
Yes
Nancy Grote, University of Washington
University of Washington
National Institute of Mental Health (NIMH)
Principal Investigator: Nancy K Grote, PhD University of Washington
University of Washington
May 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP