Effect of Exercise and Wellness Interventions on Preventing Postpartum Depression

The purpose of this study is to examine the efficacy of exercise and wellness/support
interventions for preventing postpartum depression. Specifically, 450 sedentary postpartum
women (2-6 weeks postpartum) with a history of depression prior to pregnancy will be
randomized to one of three groups each lasting six months: (1) telephone-based exercise
intervention; (2) telephone-based wellness/support intervention; or (3) usual care.
Participants will also complete a follow-up assessment session at 9 months. Participants
will be recruited via online, email, and print advertisements. The investigators will obtain
healthcare provider consent for each participant prior to randomization. The exercise
intervention will consist of a theory-based telephone intervention shown to increase
exercise among postpartum women in a previous study (Lewis et al., 2011). The
wellness/support condition will be on the same schedule as the exercise intervention and
will address several topics related to wellness. The usual care condition will receive their
choice of the exercise or wellness/support condition upon completion of their final
assessment. The primary dependent variable will be depression as measured by the Structured
Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Edinburgh Postnatal
Depression Scale (EPDS). Exercise adherence will be assessed using the 7-Day Physical
Activity Recall Interview and the ActiGraph (i.e., an accelerometer, an objective measure of
exercise).

Inclusion Criteria:

- Generally healthy

- Low active

- Currently pregnant (who will wait to be randomized until postpartum) or less than six
weeks postpartum

- History of depression

Exclusion Criteria:

- Less than 18 years of age

- Pre-existing hypertension or diabetes

- Currently exercising (defined as exercising more than 60 minutes per week)

- Enrolled in another exercise or weight management study

- Another member of the household participating in the study

- Unable to exercise for 20 minutes continuously

- Musculoskeletal problems such as arthritis, gout, osteoporosis, or back, hip or knee
pain that may interfere with exercising

- Exercise induced asthma

- Any condition that would make exercise unsafe or unwise

- Taking medication that interferes with heart rate response to exercise such as beta
blockers

- Hospitalization for a psychiatric disorder in the past six months

- Current depressive episode (based on the SCID) and/or currently receiving
antidepressant medication or psychotherapy for depression (participants who are
depressed prior to randomization will be referred to their primary physician or
psychiatrist)