Effect Of A Tailored E-health Physical Activity Intervention On Physical Activity And Depression During Postpartum

Strong evidence suggests physical activity (PA) can reduce postpartum depression risk; however many postpartum individuals do not meet PA guidelines. eHealth PA interventions are a promising approach to address common barriers to PA during postpartum. PURPOSE: The goal of this study was to test the effectiveness of a tailored eHealth PA intervention for increasing PA and decreasing depressive symptoms in postpartum individuals at high risk for depression. METHODS: We conducted a randomized controlled trial within the Kaiser Permanente Northern California health care system. Individuals at high risk for postpartum depression were randomized to an eHealth PA intervention (n = 50) or usual care (n = 49). The eHealth PA intervention group received access to an online library of 98 10-minute workout videos developed for postpartum individuals, including interaction with their infants. At baseline and 3-month follow-up, PA was measured using a modified version of the Pregnancy PA Questionnaire (sports/exercise domain) and a wrist-worn accelerometer; depressive symptoms were measured using the Patient Health Questionnaire (PHQ-8). An intent to treat analysis was conducted using linear regression adjusted for variables used in the randomization. RESULTS: Participants were 4 months postpartum at baseline with moderately severe depressive symptoms (mean PHQ-8 score = 13), on average. After adjusting for baseline depressive symptoms, race and ethnicity, number of children at home, pre-pregnancy PA level, and baseline PA, participants in the intervention group had 2.5 MET-hours per week greater self-reported moderate/vigorous intensity PA (MVPA) for intervention activities (95% CI: 0.3, 4.7). Accelerometer-measured MVPA (mean difference = -23 minutes/week, 95% CI: -161, 114) and PHQ-8 score (mean difference = -1.5, 95% CI: -4.2, 1.9) at 3 months follow-up did not statistically significantly improve compared to the usual care group. CONCLUSION: A tailored eHealth PA intervention was effective for increasing self-reported MVPA in intervention activities; however, this increase in sports/exercise MVPA may have been offset by decreases in MVPA in other domains, which may explain lack of statistically significant reduction in depressive symptoms. Supported by KP-NBA partnership and NIH grant R42DA031402.