Postpartum depression is a serious mental health problem that can impair the quality of life of young mothers. According to O’Hara and McCabe (2013), the prevalence of postpartum depression in the general population ranges between 13 and 19 percent. Antidepressant therapy is considered to be effective in treating the condition, although it poses some concerns regarding breastfeeding (Milgrom et al., 2015). The research study by Howell et al. (2014) aimed to evaluate the effectiveness of a two-step behavioral and educational intervention on the symptoms of postpartum depression in young mothers.
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The title of the research article is somewhat appropriate to the focus of the study, although it is general and does not specify the kind of intervention proposed. The abstract serves well to introduce the study by briefly explaining the rationale for the intervention, sample size, and results. The introduction, on the other hand, serves to introduce the rationale for the study, as well as the primary topic. Overall, the introduction establishes a clear purpose and objectives of the research. The problem statement is somewhat present, although it is not identified in the introduction and would benefit from clarification. The reason for conducting the study is based on the authors’ hypothesis and the previous research and it clearly defined. Nevertheless, the authors do not provide a list of definite research questions, which is a major limitation of the study’s presentation.
Literature Review and Methodology
The description of the theoretical framework for the intervention is very brief and limited to the introductory section of the report. The article would benefit from an additional section that would examine the evidence basis for the intervention in detail, thus providing a theoretical framework to support the study. Similarly, there is no separate section discussing the preliminary literature review; previous research is used to introduce the problem and to provide a rationale for the intervention in the introduction. Few references to outside sources are present in the write-up and discussion. Furthermore, the vast majority of sources referred to in the article are outdated. Overall, the literature review supports the need for the study, but is not comprehensive and lacks recent sources.
The randomized controlled trial design is appropriate to the study, as it serves well to determine the effectiveness of the chosen intervention (White, 2013). The authors describe the sampling process, intervention, and data collection processes comprehensively. The sample size is appropriate to the needs of the study, although it concerns that the authors only included white and Asian females in the sample. According to multiple studies, the prevalence of postpartum depression among immigrant, African American, and Latino females is much higher and should be addressed in research (Falah-Hassani, Shiri, Vigod, & Dennis, 2015; Ceballos, Wallace, & Goodwin, 2016).
The authors state that a separate trial for Black and Latina mothers was already conducted (Howell et al., 2012); however, they provide no rationale for their choice to separate the two populations. The data collection method used by the authors included questionnaires and interviews. The validity and reliability of the study were addressed through the use of blinding the coordinators who were unaware of the patients’ intervention status. Data analysis included t-tests and chi-square tests as appropriate, followed logistic regression analyses, and Generalized Estimating Equations (GEEs). The authors provide some rationale for the analysis methods, stating that the chosen tools served the purpose and focus of the study. In general, the analytical approach is consistent with the study questions and research design, as it provides clear information on the efficiency of the intervention.
The results are presented in text format, with main findings and statistical information explained. However, the section would benefit from additional tables and graphs that would illustrate the difference between the control group and the intervention group. The discussion section provides an exploration of the findings of the hypothesis and prior research. For instance, the authors state that the results of the present study contrasted those obtained from the research of Latina and African American mothers. The authors refer primarily to their previous studies and works as a theoretical basis for the discussion, which somewhat limits their review of the findings. Including a wider specter of literature would have helped to provide a solid theoretical framework for discussion. Nevertheless, the authors provide a thorough review of the study’s limitations and their implications.
The quality of research evidence for the study was evaluated using the Research Evidence Appraisal Tool proposed by Johns Hopkins Hospital (2012). Overall, the evaluation showed that the quality of the research study is satisfactory, although some gaps affect its reliability. For instance, the authors did not provide any information on the reliability of the tools and instruments used in the analysis. Moreover, the researchers use outdated information in their literature review and do not provide a rationale for the sample size and inclusion criteria. Finally, the presentation of statistical information in text format is not effective, and the article would benefit from using tables and graphs to illustrate the results and compare them with the outcomes of the previous study.
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All in all, the quality of the study is satisfactory. The research somewhat fills the existing gap in knowledge regarding the effectiveness of educational and behavioral therapy in the treatment of postpartum depression. Although there was no major difference in the results of the control and intervention groups, the authors explain that it is primarily due to the low initial score of postpartum depression. The same intervention tool proved to be effective in the populations with a higher incidence of postpartum depression, including African American and Latina mothers (Howell et al., 2012), which means that it can be used in my further research and practice.
Ceballos, M., Wallace, G., & Goodwin, G. (2016). Postpartum Depression among African-American and Latina mothers living in small cities, towns, and rural communities. Journal of Racial and Ethnic Health Disparities, 1(1), 1-12.
Falah-Hassani, K., Shiri, R., Vigod, S., & Dennis, C. L. (2015). Prevalence of postpartum depression among immigrant women: A systematic review and meta-analysis. Journal of Psychiatric Research, 70(2), 67-82.
Howell, E. A., Balbierz, A., Wang, J., Parides, M., Zlotnick, C., & Leventhal, H. (2012). Reducing postpartum depressive symptoms among black and Latina mothers: A randomized controlled trial. Obstetrics and Gynecology, 119(5), 942-949.
Howell, E. A., Bodnar-Deren, S., Balbierz, A., Loudon, H., Mora, P. A., Zlotnick, C., … Leventhal, H. (2014). An intervention to reduce postpartum depressive symptoms: A randomized controlled trial. Archives of Women’s Mental Health, 17(1), 57-63.
Johns Hopkins University. (2012). Johns Hopkins nursing evidence-based practice.
Milgrom, J., Gemmill, A. W., Ericksen, J., Burrows, G., Buist, A., & Reece, J. (2015). Treatment of postnatal depression with cognitive behavioural therapy, sertraline and combination therapy: A randomised controlled trial. Australian & New Zealand Journal of Psychiatry, 49(3), 236-245.
O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9(1), 379-407.
White, H. (2013). An introduction to the use of randomised control trials to evaluate development interventions. Journal of Development Effectiveness, 5(1), 30-49.