Table 1 Characteristics of selected studies

Boyd et al. [27]

Randomised controlled trial to describe the adaptations of a parenting group intervention for social media, examine the feasibility, accessibility and initial outcomes of the adapted interventions for mothers with postpartum depressive symptoms

24 mothers with a child between 1 and 3 months old recruited from three urban paediatric primary care clinics, USA

Mothers in the social media intervention group showed a greater reduction in depression than the mothers in the in-person group (F(3,15) = 8.27, 95% CI [− 18.0 to − 2.2], p < 0.01)

The experimental group also showed a greater increase in parenting competence than the control group

Average attendance was 83%, and average participant commenting on the group page was 73% for the social media intervention group, compared to in-person group average attendance of 3%

The study findings suggest the feasibility and benefit of delivering a parenting intervention via social medical for mothers with postpartum depression

The in-person group has less contact shown by low attendance rate, which could account for the lack of improvement. The study did not gather information regarding whether the participants were in behavioural treatment at the time of the study

Crockett et al. [26]

Randomised controlled trial to examine the initial acceptability, feasibility and effectiveness of the ROSE program a brief interpersonally based intervention compared to treatment as usual (TAU)

36 low-income women who were between 24 and 31 weeks’ gestation were recruited from a rural prenatal clinic in the Mississippi Delta, USA

Retention rates were very high, and the study proved the feasibility of conducting preventative intervention on rural pregnant African American women. Mean number of intervention sessions attended was 4.58 (SD = 4.95, mode was 5.00)

There was no significant difference across time 3 months after delivery between intervention and TAU for parent stress levels

Depressive symptoms significantly dropped for the ROSE program group across time F(3, 39) = 4.44, p < 0.009, d = 0.26

Effectiveness of ROSE program in improving postpartum functioning in a group of African American pregnant women in a low-income rural area

The results were based on a small sample in rural South and may not be generalisable to other regions. Degree of depressive symptoms was assessed as opposed to the presence of postnatal depression, and therefore, the clinical status remains unknown

El-Mohandes et al. [34]

A randomized controlled trial to evaluate the efficacy of a cognitive behavioural intervention delivered during pregnancy in reducing behavioural risks in the postpartum period. The risks addressed included depression etc

2913 women were recruited prenatally and on average 10 weeks postpartum in six prenatal care sites in the District of Columbia

The intervention group was more successful in resolving all risks (47% compared with 35%, p = .007, number needed to treat = 9, 95% confidence interval [CI] 5–31)

In resolving some risks (63% compared with 54%, p = .009, number needed to treat = 11, 95% CI 7–43) as compared with the usual care group

Women in the intervention group were more likely to resolve all risks (odds ratio 1.86, 95% CI 1.25–2.75, number needed to treat = 7, 95% CI 4–19) and resolve at least one risk (odds ratio 1.60, 95% CI 1.15–2.22, number needed to treat = 9, 95% CI 6–29)

An integrated multiple risk factor intervention addressing psychosocial and behavioural risks delivered mainly during pregnancy can have beneficial effects in risk reduction at postpartum period

The delivery of the postpartum booster sessions was limited to one to two sessions only, which may not have been adequate, especially in the case of depression. The study’s decision to exclude anxiety as a targeted risk factor may also have affected the efficacy of the intervention. There was also a high rate of loss to follow-up (20% of participants)

Grote et al. [41]

Pre-/post-test to examine whether culturally relevant brief interpersonal psychotherapy (IPT-B) confers greater advantages to low-income pregnant women than those that accrue from enhanced usual care in treating depression for the sample population

53 mothers who were 10 to 32 weeks’ gestation recruited from a large public hospital in Pittsburgh, USA. 33 participants in the sample were African American

Participants in the IPT-B group over time were feeling significantly less depressed with large effect size (χ² = 9.06, df = 1, p < .003; Cohen's h = .96), anxious and spending more enjoyable contact with friends and time in exciting activities compared to a usual care group

Mothers in the IBT-B group more likely to report they were doing an excellent job in taking care of their babies needs and engaging in physical contact and play with their baby compared to control group (1.47 ± .18 vs 1.78 ± .26 respectively (t = 4.47, df = 42, p < .001, d = 1.35)

In all areas, effect sizes became stronger as more time passed from baseline

Enhanced IPT-B compared with enhanced usual care showed a significant reduction in depression diagnoses and symptoms and social functioning up to 6 months postpartum in mothers

Small sample size, participants in the usual care group were more difficult to reach than participants in the intervention; these apparent differences made the study raters less likely to remain blind which poses a threat to internal validity

Holditch-Davis et al. [32]

Premuted Block Randomised Controlled trial to examine the effects of the auditory-tactile-visual-vestibular (ATVV) intervention and Kangaroo Care (KC) on maternal distress and the mother-infant relationship compared to an attention control group

240 preterm infants who weighed less than 1750 g and their mothers were recruited from 4 hospitals, USA. 64.1% of ATVV mothers, 64.2% of KC and 76.5% of control mothers were African American

KC mothers showed a rapid decline in worry than ATVV or control group

Mothers who engaged in any intervention was associated with lower parenting stress compared to mothers who did not engage in any intervention (a form of massage only-t(195) = − 3.33, p < 0.001; KC only-t(195) = − 2.90, p < 0.01; both-t (195) = − 2.66, p < 0.01)

Findings suggest that short-term interventions have important effects on mothers and their preterm infants, particularly in the first half of the first year

Limited sample size limits examining other factors that could impact parenting and maternal distress. Positive short-term effects, long term effects not as significant

Jesse et al. [43]

A longitudinal study to explore the feasibility and efficacy of a 6-week culturally tailored cognitive-behavioural intervention offered to rural, low income women at risk of antepartum depression

146 between 6- and 30-weeks pregnant low-income women recruited, USA

The cognitive-behavioural intervention significantly reduced scores for depressive symptoms for African American women at high risk (n = 43 from baseline to posttreatment (5.59 vs 2.18, p = .02) and from baseline to one-month follow-up (6.32 vs 3.14, p = .04)

For low-moderate risk African American women, the mean reduction in Beck's Depression Inventory-II scores significantly reduced from baseline and posttreatment compared to treatment as usual group (5.20 vs .70; p = .02)

The study proves the feasibility to screen, recruit and enrol rural low-income women who are at risk of postnatal depression. The study highlights the importance of integrating cognitive-behavioural intervention in the local health department to reach the at-risk, underserved group

The study only recruited low-income participants at risk for depression and therefore, cannot be generalised to other groups

Jesse et al. [42]

A pilot study aimed at reducing the risk for antepartum depression (APD) among African American and Caucasian women in a public health prenatal clinic

63 participants at risk of ADP. Of the 63 participants, 26 met all inclusion criteria. 17 women completed all six intervention sessions

94% of participants who completed their 1-month post-intervention interviews had an antepartum recovery rate of 81% (13/16, EPDS ≤ 10)

Participants reported that various aspects of the program were helpful, and they continued to use the intervention exercises after the end intervention

The brief culturally tailored cognitive behavioural intervention for African American and Caucasian rural low-income women at risk of APD was feasible, effective, and helpfulness

Small sample size with only 17 women who completed all the six intervention sessions

Mendelson et al. [25]

A randomised controlled trial to examine the intervention impact on 3 proximal outcomes that are theoretically linked with the interventions model of change and have been empirically linked with risk for depression: mood regulation, expectancies, perceived social support and coping

78, low-income perinatal women recruited from one of four home visitation programs in Baltimore City, USA

The intervention group from baseline to 6-month follow-up in the intervention group experienced 16% greater gain in mood regulation compared to the usual care group (β = 0.16, SE = 0.03, p < 0.001)

Growth in perceived social support from baseline to 6-month follow-up was 6.66 points greater in the intervention group compared to control group (β = 0.14, SE = 0.07, p < 0.05)

Surprisingly, the intervention group had a 14% greater increase in avoidant coping strategies between baseline and 6-month post-intervention follow up compared to the control group (β = 0.14, SE = 0.07, p < 0.05)

The Mothers and Babies course enhances mood regulation in participants and may facilitate the prevention of depression over time. The study is one of the few trials that were of a randomised controlled design and longitudinal assessments with 3 month and 6-month follow-ups

The study was powered to detect group differences in depressive symptoms, not in the reported proximal outcomes. The small sample size may have limited the ability to detect small effects

Lenze and Potts [44]

A randomized controlled trial for brief interpersonal psychotherapy for depression during pregnancy in a low-income population. Aimed to replicate Grote et al. [41] brief-IPT model using similar modifications to engage low-income women into treatment

Pregnant women, aged ≥ 18, between 12- and 30-weeks’ gestation were recruited from an urban prenatal clinic. Women scoring ≥ 10 on the Edinburgh Depression Scale and meeting depressive disorder criteria were randomized to either brief-IPT (n = 21) or ETAU (n = 21)

After controlling for concurrent depressive symptoms, depression scores significantly decreased in both brief-IPT and ETAU

Brief-IPT participants reported significant improvements in social support satisfaction as compared to ETAU participants

Brief-IPT participants reported high satisfaction with the program

Brief-IPT for perinatal depression is acceptable to low-income women and is helpful for improving depressive symptoms and social support

The interpretation of study results is limited due to small sample size, use of self-report measures, and lack of an active psychotherapy control group. Many participants did not participate in the full 9-session course of treatment (average sessions attended = 6, range 0–17)

Logsdon et al. [31]

To test the effectiveness of an internet-based depression intervention on seeking depression treatment

151 adolescent African American mothers who had given birth in the last year were recruited, USA

Being depressed (OR = 2.15, 95% CI 1.15–4.04, p = 0.005) and being exposed to the intervention (OR = 1.65, 95% CI 1.06–2.32, p = 0.012) increased odds for seeking treatment

Intervention independently improved attitudes (B = 2.92, p-0.018), beliefs of perceived control (B = 2.06, p = 0.012), intention to see treatment (B = 2.00, p =  < 0.001), and actually receiving treatment (B = 5.02, p < 0.001)

Internet-based intervention is an inexpensive method of increasing rates of treatment for depression in adolescent mothers

Self-reporting measures were used. Medical records were not available to report the participants' use of mental health services

Toth et al. [33]

Randomised Controlled Trial to evaluate the efficacy of interpersonal psychotherapy (IPT) for ethnically and racially diverse, economically disadvantaged women with major depressive disorder

Out of a total of 128 women, 59.4% were Black and 21.1% Hispanic low-income urban women with a 12-month-old infant, USA

IPT participants showed significantly greater decrease in depression over time compared to the enhanced community care group (ECT) B = − 4.483 (1.602), t = − 2.799, p = .005, d = − 0.519

There were significant changes in perceived stress favouring IPT B = − 0.196 (0.094), t = 2.078, p = .038, d = 0.51

IPT predicted increases in family social support compared to ECT A = 0.169 (0.088), t = 1.925, p = .054, d = 0.45)

The study demonstrated the efficacy of IPT for decreasing depression in a group of a low-income ethnically diverse group of women. The findings contribute to the importance of addressing the reluctance of low income and minority populations to access mental health services

A significant number of participants randomised to IPT declined treatment which resulted in a smaller number of participants in the sample

Sampson et al. [35]

A pilot study to test the feasibility and pre-test to post-test outcome of a Problem-Solving Therapy (PST) Intervention for Low-Income, Pregnant Women at Risk for Postpartum Depression

All participants were unemployed African American women. 85% were unmarried 61% had other children besides this pregnancy

The intervention had a 93% retention rate

There were statistically significant improvements on measures of depression symptoms after intervention

Participants had 100% completion of homework

A decrease in depression scores from pre-test to

post-test indicates promise for effectiveness of the intervention

Findings demonstrates the feasibility of implementation of a home visiting intervention for Postpartum Depression (PPD) in a community-based agency and provides the grounds for optimism about the effectiveness of a PST intervention for low-income women at risk for postpartum depression

There were some chances of social desirability bias due to the self-report nature of questionnaire and familiarity of culture matched of participants and caseworkers. Inability of the study to measure treatment fidelity by caseworker with planned approach of listening to recorded sessions

Zhang and Emory [36]

Randomised controlled pilot study which involved a 2 × 3 mixed model design, comparing treatment as usual (TAU) with the Mindful Motherhood intervention on several outcomes at pre-intervention, post-intervention, and 1-month post-intervention

65 African American women (31 = TAU; 34 = Mindful Motherhood)

Findings support the efficacy of the Mindful Motherhood training in reducing depressive symptoms, reducing reactive cortisol response, reducing pregnancy related stress and improving levels of mindfulness at post-intervention and improving pregnancy related positive experience and at 1-month follow-up

The study supports the efficacy of mindfulness-based interventions with African American women and encourage efforts to optimise recruitment and retention of underprivileged population

None of the intervention effects

appeared to have lasting impact on the participants, and treatment did not appear to impact perceived stress or baseline salivary cortisol levels