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Fathers’ Involvement: Mothers’ Perceived Benefits of Promoting Paternal Involvement Through a WhatsApp-Based Preventive Intervention for Postpartum Depression
(University of Toronto Press Inc. (UTPress), 2024-12-04)
Olga Fernández
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ALDONEY RAMIREZ, DANIELA
;
Sofia Fernández
;
Francisca Pérez
;
María Ignacia García
<jats:sec><jats:title>Introduction:</jats:title><jats:p> Despite the social and cultural changes of the recent decades, the tasks associated with childcare continue to be assumed mainly by women, increasing stress and, in some cases, negatively affecting maternal mental health. The “m-What were we thinking” (m-WWWT) intervention seeks to reduce the risk of developing postpartum depression and anxiety symptoms in women by increasing self-efficacy in caring for a newborn and perceived social support, with a special focus on the partner's role. The objective of this study was to describe the mothers’ perception of how this intervention facilitated the father's parenting involvement. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Sixty-four text messages from 25 first-time mothers participating in the m-WWWT program were analyzed using the Grounded Theory open and axial coding criteria. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> There are four subjective themes linked to fathers and parenthood. The first refers to the loss of the previous balance and increased stress with the arrival of the first child; the second, to the importance of watching the intervention videos together; the third, to the possibility of communicating regarding what is happening; and the fourth, to the shared conceptualization of parenting among the couples. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> These findings suggest that m-WWWT positively influences paternal involvement in the postpartum period, which is a relevant factor to promote maternal and infant well-being. </jats:p></jats:sec>
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Síndrome de Ovario Poliquístico y Salud Mental en Adolescentes
(2024)
María Rosario Matte
;
Juan Pablo Del Rio
;
Olga Fernández
;
Nicolás Crisosto King
<jats:p>El Síndrome de Ovario Poliquístico (SOP) es el desorden endocrino-metabólico más frecuente en las adolescentes. Se asocia a complicaciones metabólicas, cardiovasculares y reproductivas. Hallazgos recientes sugieren también una asociación con patología psiquiátrica, tanto en las pacientes afectadas como en su descendencia. En la presente actualización, se realizó una síntesis de la literatura reciente relativa a la salud mental en mujeres y adolescentes con SOP. Se realizó una búsqueda sistematizada en PubMed, Epistemonikos y Scielo de los artículos publicados en los últimos 5 años. Se confirmó que existe un aumento significativo del riesgo de presentar trastornos por ansiedad, depresión, trastornos alimenticios, trastorno obsesivo compulsivo, trastorno afectivo bipolar y psicosis en mujeres con SOP. Además, presentan riesgo de trastornos del neurodesarrollo, tales como trastorno del espectro autista y trastorno por déficit atencional e hiperactividad, tanto en ellas como en su descendencia. La hiperinsulinemia y el hiperandrogenismo podrían explicar parte de estas asociaciones, afectando la maduración del sistema nervioso central, especialmente durante la vida intrauterina y la adolescencia. El distrés derivado de las características fenotípicas físicas de la enfermedad también podría impactar la salud mental de las pacientes. Aún no se cuenta con suficientes estudios que expliquen el origen de esta correlación, ni tampoco con ensayos clínicos que aborden la salud mental de forma específica en estas pacientes. La evidencia actual sugiere la necesidad de evaluar activamente la salud mental de estas pacientes y coordinar a los distintos equipos de salud que intervengan en el manejo de la patología.</jats:p>
1
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“How it is said”: Analyses of WhatsApp communications in a postpartum depression preventive intervention
(2024)
Olga Fernández
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PÉREZ EWERT, JANET CAROLA
;
Nicolle Alamo
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Sofia Fernandez
;
Pamela Franco
<jats:p> Introduction: “m-What Were We Thinking” (m-WWWT) is an m-health, intervention oriented to prevent symptoms of postpartum depression and anxiety in first-time mothers. Mothers receive psychoeducation and socioemotional support through written communication via text-messaging (i.e., WhatsApp) with the program counsellor. Although the use of m-health interventions targeting mental health has increased, the form/style of communication through text messages between participants and program counsellors has been understudied. Objective: The aim was to describe the formal structure of the communication (Basic Forms) and the communicational intentions (Communicative Intentions) used in the messages sent by the counsellor and to determine if these are related to the post-intervention outcomes. Methods: 438 text messages sent by the counsellor to 53 first-time mothers (M = 25.32 years, SD = 4.23) who participated in the m-WWWT intervention were analyzed. The Therapeutic Activity Coding System was used to capture the communication as a “Communicative Action”. Results: The study highlighted the counsellor's frequent use of the “assertion” communicative form (82%) and attuned communicative intentions (52%) and explored (39%) in her messages. The attractors of communication were “assert to attune” and “assert to explore”, indicating an empathetic and informative communication style. With respect to their relationship with the intervention outcome, only “assert to explore” messages were positively related to maternal self-efficacy increases. The number of messages was not associated with participants’ characteristics at baseline, except for educational level. Discussion: Our results show the relevance of combining the delivery of information with a communication style that allows the counsellor to connect with the specific needs and emotional tone of the participants. </jats:p>
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Online Intervention Targeting Postnatal Depression and Anxiety in Chilean First-Time Mothers: Feasibility Trial
(2023)
COO CALCAGNI, SOLEDAD
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María Ignacia García
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PÉREZ EWERT, JANET CAROLA
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Marcia Olhaberry
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ALDONEY RAMIREZ, DANIELA
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>Internet-based interventions may positively impact maternal symptoms of postnatal depression and anxiety. This study assessed the feasibility, acceptability, perceived usefulness, and preliminary effectiveness of an m-Health version of “What Were We Thinking?” (m-WWWT).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A mixed-methods with a 2-arm randomized parallel design was used. From a total of 477 women, 157 met the inclusion criteria. 128 first-time mothers of full-term infants, aged 4–10 weeks, who received health care at primary public health centers in Chile, were randomly assigned to the experimental (EG, n = 65) or control (CG, n = 63) groups; data of 104 of them (53 and 51, respectively) was analyzed. We used percentages and rates to measure feasibility outcomes and mixed analysis of variance (ANOVA) and latent class analyses (LCA) to assess preliminary effectiveness. Participants completed questionnaires on mental health, social support, and maternal self-efficacy upon recruitment and 3 months after completing the intervention. For the qualitative component, 12 women from the EG were interviewed.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Quantitative results show good feasibility outcomes, such as high recruitment (82%), low attrition (EG = 12% and CG = 17%), and high follow-up (EG = 97% and CG = 91%) rates. Qualitative results indicate high acceptability and perceived usefulness of m-WWWT. Mixed ANOVA did not show significant differences between the groups (all p &gt;.05). However, multinomial regression analysis in LCA showed that women with low baseline symptoms of depression and anxiety benefit from the intervention (B = 0.43, 95% confidence interval 1.09–2.16).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>m-WWWT is feasible to be implemented in Chile; future studies are needed to assess the intervention’s effectiveness.</jats:p> </jats:sec>
2Scopus© Citations 7
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Episodios de Cambio y Estancamiento en Psicoterapia: Características de la comunicación verbal entre pacientes y terapeutas
(2012)
Olga Fernández
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Pablo Herrera
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Mariane Krause
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PÉREZ EWERT, JANET CAROLA
;
Nelson Valdés
Scopus© Citations 19 3
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Importancia de los Cambios Iniciales en la Psicoterapia con Adolescentes
(2015)
Olga Fernández
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PÉREZ EWERT, JANET CAROLA
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Sergio Gloger
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Mariane Krause
Scopus© Citations 9 5
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Understanding the use/non-use of an internet-based intervention complementing standard depression treatment: A qualitative study of user's experiences
(2023)
Olga Fernández
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PÉREZ EWERT, JANET CAROLA
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Sofía Fernández
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Mariane Krause
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Cristián Cáceres
<jats:sec><jats:title>Introduction</jats:title><jats:p> There is sufficient evidence about the effectiveness of internet-based interventions; however, the users’ level of adoption and utilization remains low, with this phenomenon requiring adequate explanation. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> The aim of this qualitative study was to explore the users’ perceptions and experience of a web-based program (ASCENSO), designed to complement (usual) in-person depression treatment. </jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p> Twelve participants of the ASCENSO program, comprised of adult individuals ( M = 44.3, SD = 13.4) of both genders (67% women) undergoing treatment for depression, were interviewed through semi-structured interviews. The data obtained from these interviews were analyzed utilizing a constructivist grounded theory approach. The interviews were transcribed and analyzed by trained coders. A constant comparative analysis of emergent themes was conducted. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> These show that users employ and appreciate the program when their interaction with it emulates a “humanized relationship,” that is, when the program is proactive in assisting users with their requests and when it responds in a pertinent and individualized manner to their emotional states and needs. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Our findings highlight the challenges associated with the development of algorithms capable of attracting different potential users. These should be designed to generate a virtual relationship that emulates human interaction and targets the characteristics of each user, for example, considering the specific phenomenology of their health condition, their present emotional states, and perceived needs. Elements that will vary as mental symptomatology evolve. </jats:p></jats:sec>
43Scopus© Citations 1
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Corrigendum: Parental psychological control: Maternal, adolescent, and contextual predictors
(2022)
PÉREZ EWERT, JANET CAROLA
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Paula Huerta
;
Bernardita Rubio
;
Olga Fernández
24
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Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial
(2022)
PÉREZ EWERT, JANET CAROLA
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ALDONEY RAMIREZ, DANIELA
;
Marcia Olhaberry
;
Olga Fernández
;
María I García
<jats:p> Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families. </jats:p>
16 1Scopus© Citations 4
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An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial
(2021)
PÉREZ EWERT, JANET CAROLA
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Olga Fernández
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Cristián Cáceres
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Álvaro E Carrasco
;
Markus Moessner
<jats:sec> <jats:title>Background</jats:title> <jats:p>Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform.</jats:p> </jats:sec> <jats:sec> <jats:title>Trial Registration</jats:title> <jats:p>ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467</jats:p> </jats:sec>
12 1Scopus© Citations 11

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