The study is a randomized controlled trial where the objective is to test the effectiveness of a web-based program (Mamma Mia) on postpartum depressive symptoms. The study was initiated in June 2012 and terminated in June, 2016. Mamma Mia is a fully automated internet-based intervention that was designed to be a preventive intervention for all pregnant women in Norway. The primary aim is to prevent the onset of postpartum depression. In addition, we want to explore whether Mamma Mia is health promoting in terms of enhancing subjective well-being. Mamma Mia addresses topics such as attachment, social support and relationship satisfaction, all of which are known to be related to depressive symptoms as well as psychological well-being.
Recruitment to the study started in October/November 2013, and was completed in February, 2015. Participants were recruited from hospitals (during routine ultrasound) and well-baby clinics across Norway. Participants have completed electronic surveys during pregnancy (baseline is between gestation week (GW) 22-25 and T1 is GW 37) and after birth (T2= 6 weeks postpartum, T3=3 months postpartum, T4=6 months postpartum, T5= 12 months postpartum).
Data gathering was completed May, 2016. 1500 pregnant women gave informed consent to participate and 1256 completed the first questionnaire. Upon completion of the first questionnaire, six-hundred and thirty-eight participants were randomized to Mamma Mia and 618 to the control group. The control group has received treatment as usual (i.e. routine follow-ups from general practitioners and well-baby clinics).
Preparation of data commenced during the winter of 2016, and some preliminary analyses were performed during the spring of 2016. The first publications on the effectiveness of Mamma Mia are expected in the last quarter of 2016.
Thus far, two articles have been published on Mamma Mia:
Haga, Silje Marie; Drozd, Filip; Brendryen, Håvar & Slinning, Kari (2013). Mamma Mia: A Feasibility Study of a Web-Based Intervention to Reduce the Risk of Postpartum Depression and Enhance Subjective Well-Being . JMIR Research Protocols. ISSN 1929-0748. 2(2) . doi: 10.2196/resprot.2659
Drozd, Filip; Haga, Silje Marie; Brendryen, Håvar; Slinning, Kari (2015). Mamma Mia: From theory to intervention: Mapping the development of an internet intervention for postpartum depression. JMIR Res Protoc;4(4):e120) doi:10.2196/resprot.4858
Concurrently with the RCT trial, we have performed a qualitative study where we have interviewed 66 women who have used Mamma Mia. The findings are expected to be published in the last quarter of 2016.
Every year 60 000 women give birth in Norway, of whom approximately 10-15% develop moderate to severe depressive symptoms postpartum. That is, more than 6000 women will suffer from what is frequently termed postpartum depression each year. Although not al l women with postpartum depression meet DSM-IV criteria for depression, the negative consequences of PPD can be quite severe for the woman, her child, and her partner. A very low proportion of depressed women are identified and offered help. Recent studie s have shown that interactive internet-based interventions can provide a rich, stimulating, engaging and actively supportive environment, and they have been found effective in treating depression, anxiety, phobias, diabetes, alcoholism etc. At present, no systematic efforts aimed at preventing PPD exist. A web-based intervention program that is tunneled, individualized and interactive is recently developed in Norway with the aim to prevent postpartum depression. The aim of the present project is to conduc t a randomized controlled trial to test the effectiveness of the intervention program. If successful, the program will offer a cost-effective treatment option that can be both far-reaching and easily accessed.