MEMO: an mHealth intervention to prevent the onset of depression in adolescents: a double-blind, randomised, placebo-controlled trial.

BACKGROUND: Depression often starts in adolescence making it an ideal time to intervene. We developed a universal cognitive behavioural therapy-based programme (MEMO CBT) to be delivered via multimedia mobile phone messages for teens. METHODS: We conducted a prospective multicentre, randomised, placebo-controlled superiority trial in 15 high schools in Auckland, New Zealand, comparing MEMO CBT with a control programme [MEMO control] matched for intensity and type of message but with alternative content not targeting depression. The primary outcome was the change in score on the Children's Depression Rating Scale-Revised from baseline to 12 months. Secondary outcomes included the change in scores in the self-reported Reynold's Adolescent Depression Rating Scale-Second Edition, the Moods and Feelings Questionnaire, suicidal ideation using selected items from the Youth Risk Behaviour Survey, the Pediatric Quality of Life questionnaire, 12-month period prevalence of the diagnosis of depressive disorder using the Kiddie-Schedule for Affective Disorders and Schizophrenia, and students' ratings of their satisfaction with the programme. RESULTS: Eight hundred and fifty-five students (13-17 years old, mean 14.3 years) were randomly assigned to MEMO CBT (426) or to MEMO Control (429). Participants (68% female) had a mean CDRS-R at baseline of 21.5 (SD: 5). Overall 394 (93%) from the intervention group and 392 (91%) from the control group were followed up at 12 months. At the end of the intervention (approximately 9 weeks) the mean CDRS-R scores were 20.8 in the intervention group versus 20.4 in the control group, and at 12 months they were 22.4 versus 22.4 (p value for difference in change from baseline = 0.3). There was no obvious association between the amount of the intervention viewed by participants and outcomes. CONCLUSIONS: There was no evidence of benefit from the mobile phone CBT intervention compared with a control programme. Universal depression prevention remains a challenge.

Knowledge and beliefs about nutrition and physical activity during pregnancy in women from South Auckland region, New Zealand.

BACKGROUND: Approximately 60% of women in South Auckland, a culturally diverse region in New Zealand, become pregnant with a high body mass index. However, little is known about these women's knowledge of nutrition and physical activity during pregnancy. AIMS: To assess knowledge of nutrition and physical activity during pregnancy, factors influencing eating habits and the willingness to participate in a nutritional intervention. MATERIALS AND METHODS: A total of 422 women completed the survey in late pregnancy between September and December 2013. Multivariable logistic regression investigated factors associated with infrequent healthy eating, adjusting for ethnicity and gestation at questionnaire completion. RESULTS: Ethnicity of participants was Maori (24.2%), Pacific (40.5%), Asian (12.8%) and European/Others (21.8%). Most (95.0%) reported receiving information about healthy eating while pregnant and 61% reported eating healthy frequently or very frequently. Forty-four point three per cent reported eating more in pregnancy; the commonest reasons were cravings and 'eating for two'. The adjusted odd ratios (aORs) indicated that the self-reported factors associated with infrequent healthy eating in this sample were Maori (aOR 17.66; 95% CI 8.49-36.77) and Pacific ethnicity (aOR 14.54; 95% CI 7.32-28.88); parity ≥3 (aOR 2.09; 95%CI 1.26-3.48); obesity (aOR 2.84; 95% CI 1.35-5.97); unplanned pregnancy (aOR 1.95; 95%CI 1.18-3.22); and eating takeaways ≥3 times/week (aOR 4.46; 95%CI 1.88-10.56). Of women sampled, 83.4% would likely/very likely participate in a nutritional intervention. CONCLUSION: Self-reported factors associated with infrequent healthy eating in pregnancy were identified in this sample. Our findings will assist development of a nutritional intervention for pregnant women in South Auckland.