Dugravier, R., Tubach, F., Saias, T., Guedeney, N., Pasquet, B., Purper-Ouakil, D., . . . Greacen, T. (2013). Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: The CAPEDP randomized controlled trial. PloS One, 8(8), e72216.
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | Low | Established on SES and baseline measures of the outcome; not established on race/ethnicity | No | No | Not assessed in manuscripts reviewed before 2021 |
| Study participants | Participants included 440 pregnant women: 222 women were randomly assigned to receive Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) and 218 were randomly assigned to the comparison group. Mothers were recruited and randomly assigned within 10 public maternity wards in Paris, France, before the 27th week of pregnancy. Mothers were eligible if they were first-time mothers and identified as high risk for maternal and infant depression, defined by at least one of the following risk factors: (1) less than 12 years of education, (2) planning to raise the child without the child’s father, or (3) low income. The sample of mothers was 22 years old, on average; 58 percent were French citizens; 52 percent were first-generation French immigrants; and 47 percent were low income. |
|---|---|
| Setting | Women were recruited for the study from 10 public maternity wards in Paris, France. |
| Intervention services | A team of home visiting psychologists made 14 planned home visits to the treatment group, which included 6 prenatal visits beginning in the seventh month of pregnancy and 8 visits in the first three months of the child’s life. Home visitors were trained to identify and address maternal depression, promote maternal health and attachment, and provide social and emotional support. In cases where maternal depression was identified, home visitors were instructed to escalate cases to supervisors, make additional home visits as needed, and make referrals to community mental health agencies. Of the planned 6 prenatal and 8 postnatal home visits, the treatment group received 3.2 home visits in the prenatal period and 3.7 home visits in the postnatal period, on average. |
| Comparison conditions | The comparison group received usual care. This entailed access to services provided by the French Mother and Child Protection Services, which includes access to community mental health centers. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). • Maternal depression (screening score low or screening score high) • Maternal education (less than 10 years of education or 10 or more) • Maternal substance use/disorder (yes or no) • Mother plans to raise the child without the child's father (yes or no) • Planned pregnancy (yes or no) • Mother considers herself to be poor (yes or no) • First generation immigrant (yes or no) • Mother experienced death of a parent before age 11 (yes or no) |
| Funding sources | The study was funded by the National Ministry of Health Hospital Clinical Research Programme and the National Institute for Promotion and Health Education. The study was sponsored by the Hospital of Paris Clinical Research and Development Department of the Assistance Publique. |
| Author affiliation | The study was funded in part by the French Ministry of Health, which, according to the study, funded development of the home visiting model CAPEDP. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Clinicaltrials.gov Identifier: NCT00392847. Study registration was assessed by HomVEE beginning with the 2014 review.
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Edinburgh Postnatal Depression Scale (EPDS) | FavorableUnfavorable or ambiguousNo Effect |
CAPEDP vs. usual care, Paris | 3 months postpartum | 367 mothers | Unadjusted mean = 8.60 | Unadjusted mean = 9.40 | MD = -0.80 | HomVEE calculated = -0.15 | Not statistically significant, p = 0.33 | Negative effect is favorable to the intervention. Authors estimated the p-value using linear regression and adjusting for baseline Edinburgh Postnatal Depression Scale scores. |