Characteristics of the peer volunteers.

Despite the evidence for the effectiveness of psychosocial interventions for perinatal depression, their uptake is low in Low- and Middle-Income Countries. Reasons for this include the lack of contextually adapted interventions and mental health specialists to deliver them. This study aimed to test the acceptability and feasibility of a psychosocial intervention for perinatal depression, the Thinking Healthy Programme–Peer Delivered, adapted for use in rural Malawi. A multi-method evaluation of feasibility and acceptability of the intervention was conducted using a one-group pretest-posttest quasi-experimental design and an exploratory qualitative study. Pre-post intervention change in depression scores (paired t-test) and recruitment, retention and session adherence rates were calculated. Qualitative data were collected through 29 in-depth interviews (22 mothers and 7 peer volunteers) and 1 Focus Group Discussion (18 mothers). Thematic analysis approach was used to analyse qualitative data. Seven (7) out of 8 peer volunteers were successfully trained to deliver the intervention. A total of 31 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) score ≥12 were offered intervention, of whom 24 were enrolled (recruitment rate 77.4%). Out of these 24 women, 22 completed the intervention (retention rate 91.6%). Mean difference between pre- and post-test EPDS scores one week after 8th session was 7.59 (95% CI 4.98 to 10.19), p尽管已有证据证实社会心理干预（psychosocial intervention）对围产期抑郁症（perinatal depression）的疗效，但此类干预在中低收入国家（Low- and Middle-Income Countries）的普及率仍较低。究其原因，主要在于缺乏适配当地情境的干预方案，以及能够实施此类干预的精神卫生专业人员。本研究旨在评估一款适配马拉维农村地区使用的围产期抑郁症社会心理干预方案——健康思维项目同伴实施版（Thinking Healthy Programme–Peer Delivered）的可接受性与可行性。本研究采用单组前后测类实验设计与探索性质性研究相结合的多方法评估策略，对该干预的可行性与可接受性进行评价。通过配对t检验计算抑郁量表得分的干预前后变化，并统计招募率、留存率与疗程依从率。质性数据采集方式包括29次深度访谈（22名产妇与7名同伴志愿者）以及1次焦点小组讨论（18名产妇）。质性数据采用主题分析法进行分析。8名同伴志愿者中共有7名顺利完成干预实施培训。共有31名爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale，EPDS）得分≥12的孕妇被纳入干预候选对象，最终24名完成入组（招募率为77.4%）。该24名入组孕妇中，22名顺利完成全部干预流程（留存率为91.6%）。第8次干预结束1周后的前后测EPDS得分平均差值为7.59（95%置信区间：4.98~10.19），p