Postpartum depression affects up to 1 in 5 mothers, however just 15% receive evidence-based treatment. It is associated with negative consequences for women and their families with enormous costs to the healthcare system. Postpartum depression is an ideal candidate for prevention because it is common, the window of opportunity to intervene is clear (pregnancy), and its risk factors are well-established and easily identifiable. Furthermore, women are in frequent contact with the healthcare system during pregnancy and are more motivated to improve their health during this time than at any other time in their lives. Given high rates of PPD and its adverse effects on mothers and their families, and the relative lack of efficient, effective psychotherapeutic interventions for preventing PPD, safe, novel, and efficient preventive interventions are needed. Since large 1-day workshops appear to successfully treat depression, given the widespread interest and investment of public health units across Canada in maternal and child health, Online 1-Day CBT-Based Workshops for Preventing PPD should be developed and tested for their ability to prevent PPD in Canadian women.~Based on longstanding clinical work with women at high risk for PPD, the development of a successful 1-Day CBT-Based Treatment Workshop for PPD and its delivery in-person and online, and an extensive review of the PPD prevention literature, the investigators developed the content for our prevention workshop as well as an accompanying script and intervention manual for participants in a previous pilot study. This pilot study also assessed feasibility by recruiting 32 women who took part in an online CBT-based workshop and provided feedback on its content, delivery and assessment procedures. The workshop, manual, and study protocol were subsequently refined and our experience recruiting participants in community settings into CBT treatment studies for PPD will be utilized in the current randomized controlled trial (n=410), which is aimed as assessing the effectiveness of these workshops at reducing the likelihood of developing PPD in women at risk.~Objectives of the proposed randomized controlled trial are as follows:~Primary: Can Online 1-Day CBT-Based Workshops delivered to women and other pregnant persons at increased risk for PPD and added to TAU reduce rates of PPD more than TAU alone?~Secondary: Are online 1-Day CBT-Based Workshops for preventing PPD cost-effective?~Tertiary: Can these workshops reduce the risk of developing the common comorbidities and complications of PPD (maternal anxiety, problems with the mother-infant relationship, infant temperament, maternal social support, and maternal perceived stress).~A prospective randomized controlled trial design will be used to address these objectives. The study will be advertised through our public health and community partners in Ontario, as well as on Facebook/Instagram using Facebook advertising in the province. Participants will be allocated in a 1:1 ratio to experimental (1-Day CBT Workshop in addition to TAU) or control (TAU alone) groups. Both experimental and control groups will complete data collection at baseline (before completing the 1-Day CBT workshop for experimental group participants), and at 1, 2 and 3 months postpartum.
To conduct a randomized controlled trial (n=410) examining the impact of an online cognitive behavioural therapy (CBT)-based workshop on rates of postpartum depression (PPD) when added to treatment as usual (TAU)