Problem-solving education found effective, perhaps by reducing perceived stress.
Problem-solving education (PSE) may decrease depressive symptoms in low-income mothers by reducing their perceived stress, according to a randomized study.
In a sample of 230 low-income mothers the 111 who received PSE had an 11% lower rate of perceived stress, a 15% greater rate of "behavioral activation" change, and a 17% greater rate of problem-focused coping, compared with the control group, reported Michael Silverstein, MD, MPH, of Boston Medical Center and colleagues in JAMA Network Open.
Lower levels of perceived stress were associated with decreased depressive symptoms, while behavioral activation and problem-focused coping were not correlated with depression, the researchers reported.
Each participant received six one-on-one, workbook-based PSE activities, which were conducted between 2011 and 2016 in the mothers' homes or at six different facilities that host Head Start, a federally funded program that provides early childhood education to low-income children and families.
The researchers followed up with the mothers at 6 and 12 months, with only a few participants dropping out over the course of the study. The majority of mothers (66.1%) were Hispanic, with an average age of 31.4.
"Across an array of plausible theory-based intervention mediators, improvement in perceived stress was associated with both intervention participation and depressive symptom outcomes," the investigators wrote. "However, the mechanism for much of the intervention's impact on depression remained unexplained."