80 Participants Needed

Brief Intervention for Maternal Mood and Anxiety Symptoms

Age: Any Age
Sex: Female
Trial Phase: Academic
Sponsor: University of Colorado, Denver
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment BE-OR: Brief Intervention to the Operating Room for maternal mood and anxiety symptoms?

Research shows that providing perioperative education and music therapy can help reduce anxiety in surgical patients. This suggests that similar interventions, like BE-OR, which may include educational components, could be effective in reducing anxiety for mothers in the operating room setting.12345

How is the BE-OR treatment different from other treatments for maternal mood and anxiety symptoms?

The BE-OR treatment is unique because it involves a brief intervention specifically designed for the operating room setting, which is not a common approach for addressing maternal mood and anxiety symptoms. This setting may provide immediate support and intervention during a critical time, potentially improving outcomes for mothers compared to traditional postpartum care.678910

What is the purpose of this trial?

Perinatal mental health disorders are the most prevalent perinatal comorbidity and are associated with the primary cause of maternal mortality in the United States (US) - suicide. Diagnosis of a high-risk pregnancy and cesarean delivery (CD) are both associated with increased risk for perinatal mood, anxiety, and trauma symptoms (PMATS). There is a deficit in resources and access to mental health treatment for pregnant patients, with some treatments being cost-prohibitive and requiring multiple sessions. Additionally, current approaches to addressing PMATS are reactive rather than preventive. There is evidence in the non-obstetric population that single-session cognitive behavioral therapy interventions targeting anxiety sensitivity (fear of fear) can prevent the development of anxiety and trauma symptoms when individuals are exposed to trauma. The investigators developed a low-cost, 1-hour, single-session prevention intervention that included psychoeducation about anxiety sensitivity, coupled with a brief exposure to the operating room environment and CD procedures. To revise the implementation plan and intervention (CARE: Communication, Agency, Readiness, Empowerment for cesarean delivery \[CD\]) for use in large L\&D units with a broader population of patients, a fully powered multisite randomized control trial (RCT) is needed. Before initiating such a trial, work needs to be done to modify the intervention and implementation through a process of iterative refinement to enhance the acceptability, appropriateness, and feasibility of implementation in L\&D units across the country, as well as its efficacy at engaging with the target mechanism (anxiety sensitivity). Using a logic model to guide the iterative refinement process through fast feedback loops and an atmosphere of co-creation, study investigators will gather critical input from stakeholders (individuals with lived experiences, community partners, front-line clinicians, and hospital staff) via 12 workgroups, 12 user-testing design sessions, and repeated engagement with a steering council. Following this refinement process, a treatment development pilot RCT at a large L\&D unit will assess the efficacy of CARE for CD by probing engagement with the target mechanism, as well as assess the feasibility of implementation. Finally, the updated logic model and pilot trial results will inform the development of a protocol for a multisite RCT through engagement with expert consultants in a community engagement studio and further feedback from the steering council.

Eligibility Criteria

This trial is for pregnant individuals at risk of perinatal mood, anxiety, and trauma symptoms who are scheduled for a cesarean delivery. The study aims to help those without sufficient access to mental health resources. Specific eligibility criteria were not provided.

Inclusion Criteria

Single or multiple gestation
Nulliparous or multiparous (with prior vaginal or cesarean delivery)
Antepartum admission for at least 3 days
See 3 more

Exclusion Criteria

Medical factors prohibiting participation in the intervention as determined by the inpatient obstetric medical team
Anticipated cesarean within 7 days of enrollment
I am unable to understand or make decisions about my treatment.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a 1-hour, single-session CARE intervention involving psychoeducation and brief immersive exposure to the operating room

1 hour
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention, with assessments at 3 and 12 weeks post-delivery

12 weeks
2 visits (in-person)

Treatment Details

Interventions

  • BE-OR: Brief Intervention to the Operating Room
Trial Overview The trial tests a one-hour intervention called CARE (Communication, Agency, Readiness, Empowerment) designed to prevent mental health issues by providing psychoeducation and exposure to the operating room before cesarean delivery. It involves iterative refinement with stakeholder input before a larger randomized control trial.
Participant Groups
3Treatment groups
Experimental Treatment
Active Control
Group I: InterventionExperimental Treatment1 Intervention
Intervention: (N= 40) Participants will be scheduled to receive the 1-hour, single-session CARE intervention administered by a medical and mental health provider trained in the intervention. CARE will consist of psychoeducation and brief immersive exposure to the operating room.
Group II: Interaction ControlExperimental Treatment1 Intervention
Interaction Control: (N = 20) Participants will receive a 1-hour, single-session meeting with a nurse educator that will occur within a single patient room on L\&D. This condition will provide the same front-line clinician facetime as the treatment condition but will not include the clinical content of the intervention (psychoeducation + exposure).
Group III: Care as UsualActive Control1 Intervention
Care as Usual Control: (N = 20) Participants will receive all the standard prenatal and CD education. The participants will not receive any additional face-to-face interaction with front-line clinicians as part of the study.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials
1,842
Recruited
3,028,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials
3,007
Recruited
2,852,000+

Findings from Research

A survey of 156 doulas and interviews with 27 doulas revealed that many felt unprepared to identify and address perinatal mood and anxiety disorders (PMADs) in their clients.
The study highlights the need for a standardized training model for postpartum doulas to better equip them in recognizing PMAD symptoms and referring women to appropriate treatment services.
Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Doulas' Roles and Challenges.Shklarski, L., Kalogridis, L.[2023]

References

The effects of maternal presence during anesthesia induction on the mother's anxiety and changes in children's behavior. [2015]
Strategies for decreasing patient anxiety in the perioperative setting. [2022]
Parental desire for perioperative information and informed consent: a two-phase study. [2019]
A Randomized Controlled Trial to Assess the Efficacy of a Pre-operative Virtual Operation Theatre Tour on Anxiety and Patient Satisfaction in Adults Undergoing Elective Surgery. [2023]
Reduction and management of perioperative anxiety. [2006]
The psychological effects of aromatherapy-massage in healthy postpartum mothers. [2015]
Predictors of maternal state anxiety on arrival at a Japanese hospital outpatient clinic: a cross-sectional study. [2018]
Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Doulas' Roles and Challenges. [2023]
[The prevention of depression in pregnancy and the post-partum: when to intervene?]. [2012]
10.United Statespubmed.ncbi.nlm.nih.gov
Brief Online Self-help Exercises for Postnatal Women to Improve Mood: A Pilot Study. [2022]
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