A pilot postpartum depression intervention in rural Indiana: Recruitment barriers, retention, and implementation lessons.

Authors

Elizabeth Lau, Yenupini Joyce Adams, Bernard Nahlen, Roya Ghiaseddin, Lee Gettler

Published in

Archives of psychiatric nursing. Volume 64. Pages 152210. Epub Aug 04, 2026.

Abstract

Rural postpartum women face substantial barriers to evidence-based treatment for postpartum depression (PPD). The purpose of this study was to evaluate recruitment, retention, intervention delivery, and acceptability of a four-session, group-based pilot intervention adapted for rural Indiana. An open pilot feasibility study was conducted at two rural health systems. Feasibility outcomes were compared with prespecified recruitment and retention thresholds; acceptability and participant symptom scores were summarized descriptively. Among 52 eligible women, five enrolled (9.6%) and two initiated and completed all four sessions, yielding 40.0% retention among enrollees. Prespecified recruitment (25%) and retention (60%) thresholds were not met. Among the two completers, intervention fidelity and session attendance were 100%, and participant and facilitator acceptability ratings were high. Depression scores decreased for both participants over time; however, the sample was insufficient to evaluate intervention efficacy. The tested recruitment and group-delivery model was not feasible in these settings. Findings identify barriers and design modifications needed before a larger trial, including earlier and repeated recruitment, flexible delivery options, and stronger linkage between screening and treatment initiation.

PMID:
42863904
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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