PRISM (Program of Resources, Information and Support for Mothers) Protocol for a community-randomised trial [ISRCTN03464021]

Lumley, Judith; Small, Rhonda; Brown, Stephanie; Watson, Lyndsey; Gunn, Jane; Mitchell, Creina; Dawson, Wendy
January 2003
BMC Public Health;2003, Vol. 3, p36
Academic Journal
Background: In the year after birth one in six women has a depressive illness, and 30% are still depressed, or depressed again, when their child is 2 years old, 94% experience at least one major health problem (e.g. back pain, perineal pain, mastitis, urinary or faecal incontinence), 26% experience sexual problems and almost 20% have relationship problems with partners. Women with depression report less practical and emotional support from partners, less social support overall, more negative life events, and poorer physical health. Their perceptions of factors contributing to depression are lack of support, isolation, exhaustion and physical health problems. Fewer than one in three affected women seek help in primary care despite frequent contacts. Methods/Design: PRISM aims to reduce depression and physical health problems of recent mothers through primary care strategies to increase practitioners' response to these issues, and through community-based strategies to develop broader family and community supports for recent mothers. Eligible local governments will be recruited and randomised to intervention or comparison arms, after stratification (urban/rural, size, birth numbers, extent of community activity), avoiding contiguous boundaries. Maternal depression and physical health will be measured six months after birth, in a one year cohort of mothers, in intervention and comparison communities. The sample size to detect a 20% relative reduction in depression, adjusting for cluster sampling, and estimating a population response fraction of 67% is 5740 × 2. Analysis of the physical and mental health outcomes, by intention to treat, will adjust for the correlated structure of the data.


Related Articles

  • Physician Personality Characteristics and Inquiry About Mood Symptoms in Primary Care. Duberstein, Paul R.; Chapman, Benjamin P.; Epstein, Ronald M.; McCollumn, Kelly R.; Kravitz, Richard L. // JGIM: Journal of General Internal Medicine;Nov2008, Vol. 23 Issue 11, p1791 

    Depression treatment is often initially sought from primary care physicians. To explore the influence of physician personality on depression assessments. Secondary analysis of data collected in a randomized controlled trial. Offices of primary care physicians in Rochester, NY. Forty-six...

  • The Effect of a Primary Care Practice--Based Depression Intervention on Mortality in Older Adults. Gallo, Joseph J.; Bogner, Hillary R.; Morales, Knashawn H.; Post, Edward P.; Lin, Julia Y.; Bruce, Martha L. // Annals of Internal Medicine;5/15/2007, Vol. 146 Issue 10, p689 

    Background: Few studies have tested the effects of a depression intervention on the risk for death associated with depression. Objective: To test whether an intervention to improve depression care can modify the risk for death. Design: Practice-based, randomized, controlled trial. Setting: 20...

  • Review: 3 of 4 RCTs on the treatment of adolescent depression in primary care have positive results. Stein, R. E.; Zitner, L. E.; Jensen, P. S. // Evidence Based Medicine;Feb2007, Vol. 12 Issue 1, p27 

    The article examines the effects of psychosocial, educational and supportive treatment in adolescents with mental depression found in the primary care settings. Four randomized controlled trials were conducted and examined the effectiveness of primary care practitioners in recognizing and...

  • Systematic depression screening in high-risk patients attending primary care: a pragmatic cluster-randomized trial. Romera, Irene; Montejo, Ángel L.; Aragonés, Enric; Arbesú, José Ángel; Iglesias-García, Celso; López, Silvia; Lozano, José Antonio; Pamulapati, Sireesha; Yruretagoyena, Belen; Gilaberte, Inmaculada // BMC Psychiatry;2013, Vol. 13 Issue 1, p1 

    Background: Systematic screening for depression in high-risk patients is recommended but remains controversial. The aim of this study was to assess the effectiveness of such screening in everyday clinical practice on depression recognition. Methods: A pragmatic, cluster randomized, controlled...

  • Targeted versus tailored multimedia patient engagement to enhance depression recognition and treatment in primary care: randomized controlled trial protocol for the AMEP2 study. Tancredi, Daniel J.; Slee, Christina K.; Jerant, Anthony; Franks, Peter; Nettiksimmons, Jasmine; Cipri, Camille; Gottfeld, Dustin; Huerta, Julia; Feldman, Mitchell D.; Jackson-Triche, Maja; Kelly-Reif, Steven; Hudnut, Andrew; Olson, Sarah; Shelton, Janie; Kravitz, Richard L. // BMC Health Services Research;2013, Vol. 13 Issue 1, p1 

    Background: Depression in primary care is common, yet this costly and disabling condition remains underdiagnosed and undertreated. Persisting gaps in the primary care of depression are due in part to patients' reluctance to bring depressive symptoms to the attention of their primary care...

  • Guided Self-Help Cognitive Behavioural Therapy for Depression in Primary Care: A Randomised Controlled Trial Williams, Christopher; Wilson, Philip; Morrison, Jill; McMahon, Alex; Andrew, Walker; Allan, Lesley; McConnachie, Alex; McNeill, Yvonne; Tansey, Louise // PLoS Clinical Trials;Jan2013, Vol. 8 Issue 1, p1 

    Background: Access to Cognitive behavioural therapy (CBT) for depression is limited. One solution is CBT self-help books. Trial Objectives: To assess the impact of a guided self-help CBT book (GSH-CBT) on mood, compared to treatment as usual (TAU). Hypotheses:GSH-CBT will have improved mood...

  • Is remission of depressive symptoms in primary care a realistic goal? A meta-analysis. Dawson, Marliese Y.; Michalak, Erin E.; Waraich, Paul; Anderson, J. Ellen; Lam, Raymond W. // BMC Family Practice;2004, Vol. 5, p19 

    Background: A primary goal of acute treatment for depression is clinical remission of symptoms. Most meta-analyses of remission rates involve randomized controlled trials (RCTs) using patients from psychiatric settings, but most depressed patients are treated in primary care. The goal of this...

  • Psychological treatment of depression in primary care: a meta-analysis. Cuijpers, Pim; Van Straten, Annemieke; Van Schaik, Anneke; Andersson, Gerhard // British Journal of General Practice;Feb2009, Vol. 59 Issue 559, p120 

    Background Although most depressive disorders are treated in primary care and several studies have examined the effects of psychological treatment in primary care, hardly any meta-analytic research has been conducted in which the results of these studies are integrated. Aim To integrate the...

  • Research focus.  // Primary Health Care;Jun2010, Vol. 20 Issue 5, p14 

    This section discusses two studies on the use of online cognitive behavior therapy (CBT) in the treatment of depression. A randomized controlled trial (RCT) found that online CBT is effective in primary care patients with depression. One study examined the expectations and experiences of primary...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics