A peer support intervention is defined as “the provision of emotional assistance (e.g., attentive listening), appraisal assistance (communication of information that is pertinent to self-evaluation), and informational assistance (provision of knowledge relevant to problem-solving) by a created social network member who possesses experiential knowledge of a specific behavior or stressor and similar characteristics as the target population.” (Huang et al, 2020).
In a recent review, Huang and colleagues review the effectiveness and feasibility of peer support interventions in pregnant and postpartum populations. Ten randomized controlled trials were included in the analysis, with a total of 3064 participants (1468 in the peer-delivered intervention groups and 1596 controls).
The content of interventions provided by peers focused primarily on four types of support, including informational (e.g., information about postpartum depression), emotional (e.g., listening), affirmational (e.g., support aimed at promoting self-esteem and self-confidence), and practical (e.g., child care advice) delivered in different settings.
In this review, five studies used face-to-face interventions delivered by peers at the participant’s home, hospital, or other convenient location. Telephone-based intervention was the primary form of communication in one study. In the remaining four trials, the intervention was delivered using a combination of these methods. Individual sessions typically lasted 20 minutes to 1.5–2 hours, but usually depended on the needs of the participant. The total duration of peer-support ranged from 3 weeks to 7–12 months.
Peer Support Interventions are Effective
Although there was considerable heterogeneity across the studies, the meta-analysis observed that, compared with controls, women receiving peer support interventions had a small-to-moderate beneficial effect, experiencing a decrease in levels of depressive symptoms. Seven of the studies looked at risk of postpartum depression in women receiving peer support and observed a decrease in the incidence of postpartum depression (OR = 0.69, 95% CI 0.49 to 0.96).
Many of the studies included in this review were carried out in low income countries; however, in a peer support intervention study from Cindy-Lee Dennis, PhD and colleagues from Ontario, Canada, peer support was associated with a 50% reduction in risk for postpartum depression in a group of women at high risk for PPD.
At a time when we clearly do not have enough health care providers to care for women with perinatal mood and anxiety disorders, it is essential that we develop effective and scalable interventions. Peer support interventions for pregnant and postpartum women already exist in many communities. For example, the Visiting Moms Program in the Boston area. These programs often rely on volunteers from the community and are able to offer culturally-sensitive support. While peer mentors typically receive some training and support from trained mental health professionals, this sort of intervention could significantly expand the services we are now able to provide to perinatal women.
Ruta Nonacs, MD PhD
Dennis CL, Hodnett E, Kenton L, Weston J, Zupancic J, Stewart DE, Kiss A. Effect of peer support on prevention of postnatal depression among high risk women: multisite randomized controlled trial. BMJ. 2009 Jan 15;338:a3064. doi: 10.1136/bmj.a3064. PMID: 19147637; PMCID: PMC2628301.
Huang R, Yan C, Tian Y, Lei B, Yang D, Liu D, Lei J. Effectiveness of peer support intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord. 2020 Nov 1; 276:788-796.