Text Messaging Intervention for Perinatal Depression
(Perinatal TMI Trial)
Recruiting in Palo Alto (17 mi)
Age: < 65
Sex: Female
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Massachusetts, Worcester
Disqualifiers: Major depressive episode, Panic disorder, Substance use disorder, others
No Placebo Group
Approved in 2 Jurisdictions
Trial Summary
What is the purpose of this trial?Development and preliminary testing of a text messaging intervention that will reduce the risk of a major depressive episode and worsening depressive symptoms in perinatal individuals. The system will screen pregnant individuals, send tailored text messages with links to enhanced content, and will include a peer chat function.This accessible text platform will leverage both the ease of use inherent in text messages and the power of enhanced content drawn evidence from based behavioral interventions (Interpersonal Therapy).
Will I have to stop taking my current medications?
The trial protocol does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Text Messaging Intervention for Perinatal Depression?
Research suggests that text messaging (SMS) interventions can effectively support health behaviors and mental health treatment. SMS is a widely accessible and cost-effective tool that can help patients and clinicians communicate and manage health conditions, making it a promising option for supporting mental health, including perinatal depression.
12345Is text messaging intervention generally safe for use in health-related behavior change?
Text messaging interventions have been widely used in various health-related areas, such as promoting maternal and infant health, supporting behavior change in pediatric obesity, and preventing underage drinking. While the effectiveness varies, there is no indication of safety concerns, suggesting that these interventions are generally safe for use in humans.
16789How is the Text Messaging Intervention treatment for perinatal depression different from other treatments?
The Text Messaging Intervention for perinatal depression is unique because it uses mobile phones to deliver supportive messages, making it more accessible and convenient for women who may face barriers to traditional treatments. This approach can improve access to care by integrating mental health support into everyday technology, unlike standard treatments that often require in-person visits.
1011121314Eligibility Criteria
This trial is for English-speaking individuals at least 16 years old who are pregnant and at risk of depression, as indicated by certain screening scores or a history of depression during pregnancy. Participants must be willing to use a smartphone for text messages but not currently in mental health treatment, living in an institution, planning on terminating the pregnancy, or suffering from panic or substance use disorders.Inclusion Criteria
I am at risk of postpartum depression based on my depression history or survey scores.
English speaking
I am 16 years old or older.
+2 more
Exclusion Criteria
You have been diagnosed with panic disorder or substance use disorder.
Currently in behavioral health care treatment
Permanently living in an institutional setting
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2 weeks
1 visit (virtual)
Treatment
Participants receive tailored text messages with links to enhanced content and access to a peer chat function
8 weeks
Continuous virtual engagement
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study is testing a text messaging system designed to lower the risk of major depressive episodes in perinatal individuals. It includes tailored texts with links to resources based on Interpersonal Therapy and offers a peer chat feature. The goal is to see if this intervention can help prevent worsening symptoms of depression.
2Treatment groups
Experimental Treatment
Active Control
Group I: Text4MomsExperimental Treatment1 Intervention
Texts will include video links that reinforce information relevant to Interpersonal Psychotherapy (IPT).
Group II: Educational ControlActive Control1 Intervention
The control condition will be limited to texts related to pregnancy, nutrition and sleep. We will avoid elements that have behavioral therapeutic effects. Although this condition is meant to constitute time and attention control, we will include material on recognizing depression and links to ways to attain depression treatment and suicide hotline information.
Text Messaging Intervention is already approved in United States, Canada for the following indications:
🇺🇸 Approved in United States as Text Messaging Intervention for:
- Perinatal Depression Risk Reduction
🇨🇦 Approved in Canada as Text Messaging Intervention for:
- Perinatal Depression Risk Reduction
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
UMass Chan Medical SchoolWorcester, MA
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Who Is Running the Clinical Trial?
University of Massachusetts, WorcesterLead Sponsor
Michigan State UniversityCollaborator
National Institute of Mental Health (NIMH)Collaborator
Yale UniversityCollaborator
Worcester Polytechnic InstituteCollaborator
References
Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: a qualitative study using parent focus groups and interviews. [2021]Text messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children.
Text Message Behavioral Interventions: From Here to Where? [2022]Text messaging is an efficient and personal electronic form of communication, making it an ideal modality for remote delivery of behavioral interventions. The ubiquity of cell phones and short message service (SMS) worldwide allow the possibility of SMS behavioral inteventions to impact global health. Studies to date suggest that SMS interventions can effectively support health behaviors and may offer advantages compared to other forms of computerized interventions. Program features optimizing user engagament and persuasiveness are suggested to mediate SMS intervention effect. Future research is tasked with identifying what SMS features are useful to which individuals at what times to best help them initiate and maintain health behaviors.
Short message service can be a promising tool for psychiatric patients and clinicians. [2015]Short message service (SMS), commonly referred to as text messaging, allows instantaneous communication between mobile telephones and other systems via 160-character messages. SMS has a wide reach, and thus researchers and public health officials have considered using this platform for health-related communication. Today, as our society continues to integrate components of automation in various forms and levels of human interaction, and with the increasing ubiquity of mobile technology in health care, technology-delivered health interventions such as SMS offer a creative alternative that can be a valuable tool to assist mental health patients in their own treatment and recovery and for the mental health clinicians who are responsible for providing care and its delivery.
The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial. [2020]In recent years, attempts have been made to use mobile phone text messaging (short message service, SMS) to achieve positive results for a range of health issues. Reports on the impact of maternal education programs based on this widely available, inexpensive, and instant communication tool are sparse.
Enhancement of care through self-monitoring and tailored feedback via text messaging and their use in the treatment of childhood overweight. [2018]This paper first illustrates the general potential of the short message service (SMS) for symptom and behavior monitoring and the provision of tailored feedback. Second, an SMS-based maintenance treatment (SMSMT) is introduced aimed at enhancing the treatment of childhood overweight.
Use of text messaging for maternal and infant health: a systematic review of the literature. [2022]Text messaging is an increasingly popular communication tool in health interventions, but has been little studied in maternal and infant health. This literature review evaluates studies of text messaging that may be applied to the promotion of maternal and infant health. Articles from peer-reviewed journals published before June 2012 were included if they were experimental or quasi-experimental studies of behaviors endorsed either by the American College of Obstetrics and Gynecology, the American Pediatrics Association, or the United States Preventive Services Task Force; included reproductive age women (12-50 years) or infants up to 2 years of age; and were available in English. Qualitative studies of text messaging specific to pregnant women were also included. Studies were compared and contrasted by key variables, including: design, time-period, study population, and results. Forty-eight articles were included, 30 of which were randomized controlled trials. Interventions vary greatly in effectiveness and soundness of methodology, but collectively indicate that there is a wide range of preventative behaviors that text message interventions can effectively promote, including smoking cessation, diabetes control, appointment reminders, medication adherence, weight loss, and vaccine uptake. Common methodological issues include not accounting for attention affect and not aligning text message content to measured outcomes. Those interventions that are based on an established theory of behavior change and use motivational as opposed to informational language are more likely to be successful. Building on the growing body of evidence for text message interventions reviewed here, as well as the growing popularity of text messaging as a medium, researchers should be able to use this technology to engage difficult to reach populations.
Developing an SMS Intervention for the Prevention of Underage Drinking: Results From Focus Groups. [2021]There is growing evidence that text messaging-"short message service" (SMS)-is useful for health promotion and behavior change. SMS has become a preferred channel of communication among adolescents. Despite burgeoning interest, there remains a critical need for formative research regarding developmentally and culturally appropriate SMS-based health promotion with teenagers.
Text4baby: development and implementation of a national text messaging health information service. [2021]Text4baby is the first free national health text messaging service in the United States that aims to provide timely information to pregnant women and new mothers to help them improve their health and the health of their babies. Here we describe the development of the text messages and the large public-private partnership that led to the national launch of the service in 2010. Promotion at the local, state, and national levels produced rapid uptake across the United States. More than 320,000 people enrolled with text4baby between February 2010 and March 2012. Further evaluations of the effectiveness of the service are ongoing; however, important lessons can be learned from its development and uptake.
Effects of Telephone and Short Message Service Support on Infant Feeding Practices, "Tummy Time," and Screen Time at 6 and 12 Months of Child Age: A 3-Group Randomized Clinical Trial. [2021]There is limited information as to whether telephone or short message service (SMS) support is effective in improving infant feeding practices and tummy time and reducing screen time.
Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women. [2023]Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity and mortality, and compared SMS communication patterns between women with and without perinatal depression.
Text messaging to support a perinatal collaborative care model for depression: A multi-methods inquiry. [2022]Mental health care integrated into obstetric settings improves access to perinatal depression treatments. Digital interactions such as text messaging between patient and provider can further improve access. We describe the use of text messaging within a perinatal Collaborative Care (CC) program, and explore the association of text messaging content with perinatal depression outcomes.
Feasibility of perinatal mood screening and text messaging on patients' personal smartphones. [2020]Screens and adjunctive treatments for perinatal mood are available, but barriers prevent many women from receiving them. Mobile technology may help bypass barriers. The purpose of this study was to evaluate the feasibility of screening and texting perinatal women via their personal smartphones. This prospective cohort study enrolled 203 pregnant and postpartum women receiving obstetric care at a Midwestern US academic medical center. Participants received one electronic mood screen and three text messages per week for two weeks. Texts were based on the Mothers and Babies Course, a CBT-based preventative program that addresses limited social support, lack of pleasant activities, and harmful thought patterns. Feasibility was defined as the ability to take the mood screen and receive texts without technical difficulties. Demographic variables were paired with results. Insurance type (private or public) was used as a proxy for socioeconomic status. Pearson chi-squared tests were used to analyze the data. A text-based satisfaction survey was also administered. The sample was 72% privately insured and 28% publicly insured. Sixty-seven percent completed electronic screening. Screen completion was significantly associated with private insurance (OR = 3.8, 95% CI 2.00-7.30) and "married" status (OR = 1.93, 95% CI 1.01-3.70). Most survey respondents (92%) found it easy to receive the texts, and 76% responded with very favorable comments about the texts. Smartphone mood screening and supportive texting were technically feasible. Screen completion was lower among single women with public insurance.
Initial outcomes from a 4-week follow-up study of the Text4baby program in the military women's population: randomized controlled trial. [2022]The use of mobile phone technologies for health promotion and disease prevention has advanced rapidly in recent years. Text4baby is a theory-based mobile health (mHealth) program in which text messages are delivered to pregnant women and new mothers to improve their health care beliefs and behaviors and improve health status and clinical outcomes. Recent evaluations of Text4baby have found that it improves targeted health attitudes and beliefs, but effects on behavior have not yet been determined.
Evaluating the Feasibility, Acceptability, and Preliminary Efficacy of SupportMoms-Uganda, an mHealth-Based Patient-Centered Social Support Intervention to Improve the Use of Maternity Services Among Pregnant Women in Rural Southwestern Uganda: Randomized Controlled Trial. [2023]SMS text messaging and other mobile health (mHealth) interventions may improve knowledge transfer, strengthen access to social support (SS), and promote positive health behaviors among women in the perinatal period. However, few mHealth apps have been taken to scale in sub-Saharan Africa.