The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized controlled trial

Lei Yang; Yiping Nan; Jie Zhou; Jingwen Sun; Lanting Huo; Fang Liu; Duolao Wang; Atif Rahman; Xiaomei Li

doi:10.1016/j.psychres.2025.116639

The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized controlled trial

Lei Yang, Yiping Nan, Jie Zhou, Jingwen Sun, Lanting Huo, Fang Liu, Duolao Wang, Atif Rahman, Xiaomei Li

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial.

Methods: Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up.

Results: A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015).

Conclusions: Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.

Original language	English
Article number	116639
Journal	Psychiatry Research
Volume	351
Early online date	11 Jul 2025
DOIs	https://doi.org/10.1016/j.psychres.2025.116639
Publication status	Published - 1 Sept 2025

Keywords

Digital intervention
Postpartum depression
Postpartum mothers
Randomized controlled trial
Thinking healthy program

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.psychres.2025.116639Licence: CC BY-NC

Manuscript-R2- clean versionAccepted author manuscript, 444 KBLicence: CC BY-NC-ND

Cite this

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title = "The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized controlled trial",

abstract = "Background: Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial. Methods: Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up. Results: A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015). Conclusions: Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.",

keywords = "Digital intervention, Postpartum depression, Postpartum mothers, Randomized controlled trial, Thinking healthy program",

author = "Lei Yang and Yiping Nan and Jie Zhou and Jingwen Sun and Lanting Huo and Fang Liu and Duolao Wang and Atif Rahman and Xiaomei Li",

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T1 - The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized controlled trial

AU - Yang, Lei

AU - Nan, Yiping

AU - Zhou, Jie

AU - Sun, Jingwen

AU - Huo, Lanting

AU - Liu, Fang

AU - Wang, Duolao

AU - Rahman, Atif

AU - Li, Xiaomei

PY - 2025/9/1

Y1 - 2025/9/1

N2 - Background: Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial. Methods: Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up. Results: A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015). Conclusions: Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.

AB - Background: Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial. Methods: Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up. Results: A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015). Conclusions: Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.

KW - Digital intervention

KW - Postpartum depression

KW - Postpartum mothers

KW - Randomized controlled trial

KW - Thinking healthy program

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DO - 10.1016/j.psychres.2025.116639

M3 - Article

AN - SCOPUS:105010519573

SN - 0165-1781

VL - 351

JO - Psychiatry Research

JF - Psychiatry Research

M1 - 116639

ER -

The effectiveness of a nurse-assisted digital thinking healthy program for postpartum depression: A randomized controlled trial

Abstract

Keywords

UN SDGs

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