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Key PointsQuestionAre nonspecialist providers (such as lay counselors, nurses, midwives, and teachers with no formal training in counseling interventions) effective at preventing and treating perinatal depression and anxiety, and what are the relevant implementation processes for nonspecialist-delivered interventions? FindingsThis systematic review of 46 trials (18 321 participants) and meta-analysis of 44 trials (18 101 participants) found that, compared with control groups, nonspecialist-delivered interventions were associated with lower depressive and anxiety symptoms for both preventive and treatment interventions, but there was high heterogeneity among the included trials. The majority of interventions were implemented in Australia, UK, and US, conducted by nurses and midwives, and delivered in person, in person combined with the telephone, or via telephone only, with only 2 interventions delivered online. MeaningThis study found evidence in high-income countries to support that nonspecialist providers may be effective in preventing and treating perinatal depressive and anxiety symptoms, which suggests that integrating nonspecialist providers to deliver evidence-based counseling interventions has the potential to address the significant burden of perinatal depression and anxiety worldwide.
JAMA Psychiatry – American Medical Association
Published: May 3, 2021
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