Funded Projects

Exercise Intervention for Preventing Perinatal Depression Among Low Income Women

Grantee: Regents of the University of Minnesota
Principal Investigator: Beth Lewis
Project Number: R40MC29454
Project Date: 04/01/2016

Final Report

Exercise Intervention for Preventing Perinatal Depression Among Low Income Women Final Report (PDF)

Age group(s)

• Women/Maternal
• Prenatal
• Perinatal/Infancy (0-12 months)

Targeted/Underserved Population

• African American
• Asian/Pacific Islander
• Hispanic/Latino
• Native American/Alaskan Native

Abstract

Our proposal is in response to HRSA-16-032 (R40 MCH Research (MCHR)). Approximately 15% of women experience perinatal depression (depression during pregnancy or postpartum). Furthermore, 38% of low income women experience postpartum depression (Gree- Smith et al., 2012). Perinatal depression is associated with numerous maternal (e.g., weight retention), infant (e.g., poor infant-child bond), and lifespan (e.g., behavior problems) consequences (Barker et al., 2011, Herring et al., 2008, Hipwell et al., 2000). Psychosocial interventions are efficacious for perinatal depression; however, only 10% of women seek treatment (Oppo et al., 2009). There is a need for innovative, low cost interventions that can be integrated within existing community-based programs serving women in need (e.g., low income women). Preliminary evidence indicates that exercise may be a novel, efficacious intervention for preventing perinatal depression (Daley et al., 2015); however, additional research is needed. This proposal addresses Strategy Research Issue #IV (promotes the healthy development of MCH populations) and could impact several MCH Block Grant National Performance Priority Areas (interconception health and, indirectly, breastfeeding and safe sleep given depression is related to these infant outcomes; USDHHS, HRSA, 2015). Healthy People 2020 objectives are also addressed including: (1) MICH-34: Decrease the proportion of women delivering a live birth who experience postpartum depressive symptoms; (2) PA-1: Reduce the proportion of adults who engage in no leisure-time physical activity; (3) NWS-11: Prevent inappropriate weight gain in youth and adults; (4) MICH-20: Increase the proportion of infants who are put to sleep on their backs; and (5) MICH-21: Increase the proportion of infants who are breastfed. The primary aim of this study is to examine the efficacy of a novel exercise intervention designed to prevent perinatal depression among women attending federally qualified health centers serving high risk women. Possible effects on gestational weight gain and retention will also be explored. This study will build upon the study team's previous work by recruiting low income women and integrating the intervention with community-based clinics. Participants (n=200) who are low income and pregnant (less than 20 weeks) will be randomly assigned to either a telephone-based intervention that has been previously shown to increase exercise among perinatal women (Lewis et al., 2011) or usual care. With regard to the primary aim, we predict that participants randomized to the exercise intervention will report fewer depressive symptoms (as measured by Edinburgh Postnatal Depression Scale) at 36 weeks gestation and three months postpartum than women in the usual care condition. Our secondary aim is to examine the efficacy of an exercise intervention on moderating prenatal weight gain and facilitating postpartum weight loss. We will also examine several potential mediators (e.g., depression coping, self-efficacy, perceived stress, sleep, fatigue) and the effect of the exercise intervention on maternal (e.g., hypertension, gestational diabetes, mode of delivery) and infant outcomes (e.g., birth weight, gestational age at delivery, breastfeeding, safe sleep).