(294) HUGS/Abrazos: A Novel Community Initiative to Improve Perinatal Mental Health in a High-Risk Urban Population

To evaluate the impact of a community-based intervention on perinatal mental health in an urban population during the COVID-19 pandemic

Study Design: We performed a prospective cohort study of pregnant and postpartum individuals referred to a new community-based intervention, Helping Us Grow Stronger (HUGS/Abrazos). Participants received four virtual acute behavioral health sessions from a cognitive behavioral therapy (CBT) and trauma-informed care trained social worker, four resource navigation visits with a community health worker, and a care package. Participants completed validated survey instruments assessing mood, anxiety, stress, food insecurity, experience of discrimination, and program satisfaction before and after program completion.

Results: 103 participants (Table) completed surveys before and after the program. In this urban obstetric population, there were high rates of food insecurity (54%), experiences of discrimination (61%), and COVID-19 infection in pregnancy (62%). Program satisfaction was high (Table). The program was associated with improvement in Edinburgh Postnatal Depression (EPDS) scores (mean 8.3 pre-HUGS vs 6.7 +-5.6 post, p=0.001), with significant reduction in those screened positive for depression (46/103 pre- vs 31/103 post, p< 0.001); improvement in Perceived Stress Scale (PSS) scores (mean 15.4 +- 8.0 (SD) pre vs 13.5+- 7.1 post, p=0.003) with significant reduction in those with moderate or high stress (56/103 pre vs 49/103 post, p< 0.001); and reduction in those screened positive on the PROMIS anxiety scale (46/103 pre vs 40/103 post, p< 0.001). In stratified analyses (Figure), food insecurity, COVID-19 in pregnancy, and experiences of discrimination were associated with improvement in PSS scores and PROMIS anxiety score.

Conclusion:

In a diverse urban cohort, this novel community-based intervention led to improvement in depression, perceived stress, and anxiety, particularly for those with toxic life stressors in pregnancy including food insecurity, discrimination, and COVID-19 infection.