Speaker
Description
Background: Postpartum depression affects approximately 30% of mothers in urban informal settlements in Nairobi, Kenya, with adolescent mothers facing particularly high risks alongside compromised family functioning. Current evidence-based treatments like Interpersonal Therapy (IPT) have demonstrated effectiveness for postpartum depression in low- and middle-income countries and adolescent populations, but these interventions are primarily tested in Global North contexts and may be resource-intensive with standard 8-session protocols potentially leading to higher dropout rates.
Objective: This feasibility study examined whether a shortened Mini-IPT intervention (4 sessions) delivered by non-specialist healthcare workers could effectively reduce depression and improve family functioning among adolescent mothers in Kenya. We hypothesized that both Mini-IPT and Full IPT would reduce depression scores and improve family functioning compared to treatment as usual, with Mini-IPT potentially offering advantages in resource utilization and retention through an integrated systems approach.
Methods: A three-arm longitudinal feasibility study was conducted with 122 pregnant adolescent girls (ages 13-18) from Kariobangi and Kangemi informal settlements who scored ≥10 on the Edinburgh Postnatal Depression Scale. Participants were randomized to treatment as usual (TAU; n=44), Mini-IPT with 4 sessions (n=38), or Full IPT with 8 sessions (n=40). Primary outcomes included depression symptoms measured by the Patient Health Questionnaire-9 (PHQ-9) and family functioning assessed by the Family Functioning Composite (FFC) scores. Assessments were conducted at baseline, immediately post-intervention, and at follow-up.
Results: The final sample included 101 participants post-intervention and 91 at follow-up. Both Full IPT and Mini-IPT groups showed significant reductions in depression compared to TAU immediately post-intervention; however, improvements in the Mini-IPT group were not sustained at follow-up. No significant changes in family functioning were observed across any groups. Mini-IPT demonstrated the lowest attrition rates both post-intervention and at follow-up, though differences were not statistically significant. The study was underpowered to detect smaller effect sizes.
Conclusions: Full IPT demonstrated sustained reduction in depression symptoms among adolescent mothers, while Mini-IPT showed initial promise but lacked durability. The absence of family functioning improvements suggests need for targeted family-focused interventions. Despite lower attrition rates for Mini-IPT, further research with adequate statistical power is required to establish its effectiveness. Future studies should consider implementing well-powered designs and exploring effectiveness in diverse settings, including rural populations, to inform scalable mental health interventions for vulnerable adolescent mothers.
Keywords: postpartum depression; adolescent mothers; interpersonal therapy; family functioning; Kenya; feasibility study
