A Trauma-Informed Primary Health Care Intervention to Prevent Postpartum Depression After Disaster

NCT07329270 | Completed

• 2 other identifiers: BAP-2023.02.002TUBİTAK424K188
• Study Type: interventional
• Target: 106
• Locations: 1 country
• Sites: 1

Brief Summary

Postpartum depression is a common mental health problem that can affect women after childbirth and may have long-lasting consequences for both mothers and infants. The risk of postpartum depression is substantially higher in disaster-affected regions due to exposure to trauma, loss, displacement, disruption of health services, and ongoing psychosocial stressors. This study aimed to develop and evaluate a trauma-informed postpartum depression prevention program for women living in earthquake-affected regions of Türkiye using a sequential mixed-methods design. In the first phase, the program was developed based on qualitative findings obtained through in-depth interviews with postpartum women. In the second phase, the effectiveness of the newly developed program was tested using an experimental design. During the qualitative phase, in-depth interviews were conducted with 24 postpartum women, and data were analyzed using interpretative phenomenological analysis (IPA) to explore women's lived experiences, perceived needs, and priorities related to mental health and psychosocial support after childbirth in a disaster context. The findings from this phase informed the content, structure, and delivery of the trauma-informed prevention program. In the quantitative phase, the program was evaluated through a randomized controlled trial. Eligible postpartum women were randomly assigned either to the trauma-informed prevention program or to a comparison group receiving usual primary health care services. Postpartum depressive symptoms were assessed using validated measures. The primary objective of the study was to evaluate the effectiveness of the trauma-informed program in reducing postpartum depressive symptoms. The findings are expected to contribute to evidence-based, trauma-informed approaches for preventing postpartum depression in disaster-affected settings.

Conditions

Postpartum Depression (PPD)

Keywords

postpartum depression | trauma-informed care | disaster response | maternal mental health | primary health care | resilience | Türkiye earthquakes

Outcome Measures

Primary Outcomes (1)

• Postpartum Depressive Symptoms

  Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), a validated 10-item self-report instrument widely used for screening depressive symptoms during the postpartum period. Higher scores indicate greater severity of depressive symptoms. The primary outcome was the change in EPDS scores from baseline to six months post-intervention.

  Baseline and at infant age 6 months.

Secondary Outcomes (1)

• Perceived Stress

  Baseline and at infant age 6 months.

Other Outcomes (2)

• Coping Perception

  Baseline and at infant age 6 months.

• Perceived social support

  Baseline and at infant age 6 months.

Study Arms (2)

Trauma-Informed Postpartum Depression Prevention Program

EXPERIMENTAL

Participants in this arm received a trauma-informed postpartum depression prevention program developed by the research team. The program was informed by findings from an initial qualitative phase using interpretative phenomenological analysis and was integrated into routine primary health care services in earthquake-affected regions. The intervention focused on early identification of psychological distress, psychoeducation, emotional support, strengthening coping skills, and enhancing social support.

Behavioral: Trauma-Informed Preventive Intervention

No Intervention / Usual Care

NO INTERVENTION

Participants in this arm received usual postpartum care provided through routine primary health care services without a structured trauma-informed mental health prevention component.

Interventions

Trauma-Informed Preventive Intervention BEHAVIORAL

This is a newly developed trauma-informed postpartum depression prevention program designed for women living in earthquake-affected regions. The program was developed by the research team based on qualitative findings from in-depth interviews with postpartum women analyzed using interpretative phenomenological analysis. It was delivered within primary health care settings by trained health care professionals and included psychoeducation, emotional support, coping skills enhancement, and facilitation of social support and referral when needed.

Trauma-Informed Postpartum Depression Prevention Program

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Postpartum women aged 18 years or older
• Having an infant younger than 60 days at the time of enrollment
• Living in earthquake-affected regions of Türkiye
• Receiving routine postpartum follow-up through primary health care services
• Able to communicate in Turkish
• Provided written informed consent

You may not qualify if:

• History of a diagnosed psychiatric disorder prior to the current postpartum period
• Severe medical conditions requiring specialized care
• Cognitive impairment or any con

Sponsors & Collaborators

• Istanbul Bilgi University: lead

Study Sites (1)

Narlıca 2 No'lu Family Physician Center

Hatay, Antakya, Turkey (Türkiye)

Location

Related Publications (1)

• Manuscript under peer review.

  BACKGROUND

MeSH Terms

Conditions

Depression, Postpartum

Condition Hierarchy (Ancestors)

Puerperal Disorders; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Depressive Disorder; Mood Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants were masked to group assignment. Due to the nature of the psychosocial intervention, care providers were not masked.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Public Health and Social Work / Dean, Faculty of Health Sciences

Model Details: Participants were assigned in parallel to either a trauma-informed postpartum depression prevention program or to usual postpartum care. The intervention was developed using findings from an initial qualitative phase and evaluated using an experimental design.

Study Record Dates

• First Submitted: December 29, 2025
• First Posted: January 9, 2026
• Study Start: November 1, 2024
• Primary Completion: July 1, 2025
• Study Completion: July 30, 2025
• Last Updated: January 9, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)