Evidence map›Paper›PMID 19147636›Full record

Trial reportBMJ (Clinical research ed.)2009

Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care.

C Jane Morrell, Pauline Slade, Rachel Warner, Graham Paley, Simon Dixon, Stephen J Walters, Traolach Brugha, Michael Barkham, Gareth J Parry, Jon Nicholl

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 12 pooled it
23.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 12 syntheses or guidelines pooled it, 232 citations in OpenAlex.

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  12. Counselling for mental health and psychosocial problems in primary care.The Cochrane database of systematic reviews · 2011
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

C Jane MorrellSchool of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA. j.morrell@hud.ac.uk
Pauline Slade
Rachel Warner
Graham Paley
Simon Dixon
Stephen J Walters
Traolach Brugha
Michael Barkham
Gareth J Parry
Jon Nicholl
University of Sheffield · GBHarvard University · USLeeds Community Healthcare NHS Trust · GBMental Health Services · DKUniversity of Leicester · GB

Funding

Department of Health 99/33/51
6 · The paper itself

Abstract

objectiveTo evaluate benefits for postnatal women of two psychologically informed interventions by health visitors.

designProspective cluster trial randomised by general practice, with 18 month follow-up.

setting101 general practices in Trent, England.

participants2749 women allocated to intervention, 1335 to control.

interventionHealth visitors (n=89 63 clusters) were trained to identify depressive symptoms at six to eight weeks postnatally using the Edinburgh postnatal depression scale (EPDS) and clinical assessment and also trained in providing psychologically informed sessions based on cognitive behavioural or person centred principles for an hour a week for eight weeks. Health visitors in the control group (n=49 38 clusters) provided usual care.

main outcome measuresScore >or=12 on the Edinburgh postnatal depression scale at six months. Secondary outcomes were mean Edinburgh postnatal depression scale, clinical outcomes in routine evaluation-outcome measure (CORE-OM), state-trait anxiety inventory (STAI), SF-12, and parenting stress index short form (PSI-SF) scores at six, 12, 18 months.

results4084 eligible women consented and 595 women had a six week EPDS score >or=12. Of these, 418 had EPDS scores available at six weeks and six months. At six months, 34% women (93/271) in the intervention group and 46% (67/147) in the control group had an EPDS score >or=12. The odds ratio for score >or=12 at six months was 0.62 (95% confidence interval 0.40 to 0.97, P=0.036) for women in the intervention group compared with women in the control group. After adjustment for covariates, the odds ratio was 0.60 (0.38 to 0.95, P=0.028). At six months, 12.4% (234/1880) of all women in the intervention group and 16.7% (166/995) of all women in the control group had scores >or=12 (0.67, 0.51 to 0.87, P=0.003). Benefit for women in the intervention group with a six week EPDS score >or=12 and for all women was maintained at 12 months postnatally. There was no differential benefit for either psychological approach over the other.

conclusionTraining health visitors to assess women, identify symptoms of postnatal depression, and deliver psychologically informed sessions was clinically effective at six and 12 months postnatally compared with usual care.

trial registrationISRCTN92195776.

Indexed as

Cognitive Behavioral TherapyAdolescentAdultCluster AnalysisCommunity Health NursingDepression, PostpartumEnglandFamily PracticeFemaleFollow-Up StudiesHumansPatient-Centered CareProspective StudiesPsychologyTreatment OutcomeYoung Adult

Identifiers

PMID19147636
PMCPMC2628298
OpenAlexW2164801503

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.