• Susan Gennaro, MelnykBernadette MazurekBMCollege of Nursing, The Ohio State University, Columbus, Ohio., Laura A Szalacha, Anne M Gibeau, Jacqueline Hoying, Caitlin M O'Connor, Andrea R Cooper, and Melanie M Aviles.
• William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.
• Am J Prev Med. 2024 May 1; 66 (5): 797808797-808.

IntroductionPerinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined.Study DesignThis study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content.Setting/ParticipantsBlack and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate.InterventionParticipants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting.Main Outcome MeasuresOutcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors.ResultsThere were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased.ConclusionsBoth cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens.Trial RegistrationThis study is registered with clinicaltrials.gov NCT03416010.Copyright © 2024 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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