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Record W4413338974 · doi:10.1186/s12916-025-04272-y

Bridges to treatment satisfaction: the roles of trauma, social support, race and ethnicity among perinatal women receiving behavioural activation therapy

2025· article· en· W4413338974 on OpenAlexaff
Maya Zaidan, Andrea Lawson, Nicole Andrejek, Kate Walsh, Cindy‐Lee Dennis, Samantha Meltzer‐Brody, Richard K. Silver, Alison M. Stuebe, Simone N. Vigod, Daisy R. Singla

Bibliographic record

VenueBMC Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicMaternal Mental Health During Pregnancy and Postpartum
Canadian institutionsWomen's College HospitalUniversity of TorontoCentre for Addiction and Mental HealthLunenfeld-Tanenbaum Research Institute
FundersPatient-Centered Outcomes Research Institute
KeywordsMedicineEthnic groupSocial supportAnxietyClinical psychologyPsychiatryPsychologyPsychotherapist

Abstract

fetched live from OpenAlex

BACKGROUND: High treatment satisfaction is related to improved treatment adherence and outcomes in psychotherapy research. Satisfaction with psychotherapy treatment among racially and ethnically diverse perinatal populations with post-traumatic stress (PTS) remains understudied. The aims of this study are to examine the relations between PTS symptoms, perceived social support, and race and ethnicity, and treatment satisfaction among perinatal women receiving behavioural activation (BA) psychotherapy. METHODS: This is a mixed-methods study of the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial-a large, multi-site, non-inferiority trial for perinatal women with depressive and anxiety symptoms (NCT04153864). A two-sample t-test compared baseline PTS symptoms, social support, and treatment satisfaction between participants from white and racial and ethnic minority groups. Hierarchical multiple linear regression examined whether PTS symptoms, perceived social support, race and ethnicity predicted treatment satisfaction. Content analysis of open-ended responses explored facilitators and modifications for improving treatment satisfaction across PTS symptom severity and race and ethnicity. RESULTS: Of 1230 women, 1119 (90.98%) had ≥ 1 BA session. Compared to their white counterparts, baseline PTS symptom severity was higher (t(1087) = - 4.98; p < 0.001; 95% CI = - 2.23, - 0.97), and social support lower (t(1087) = 8.05; p < 0.001; 95% CI = 0.43, 0.71) among racial and ethnic minority women. Lower baseline PTS symptom severity (β = - 0.009; 95% CI = - 0.016, - 0.002) and higher perceived social support (β = 0.042; 95% CI = 0.013, 0.072) were associated with higher post-treatment satisfaction across the sample. Descriptive analysis revealed no differences in treatment satisfaction across race and ethnicity; treatment satisfaction was higher for racial and ethnic minority women when social support was added to the regression model (β = 0.077; 95% CI = 0.005, 0.149). Content analysis (n = 807) revealed no differences by PTS symptoms severity or race and ethnicity across reported facilitators and modifications. BA as a treatment modality (n = 446, 55.27%) was a key facilitator; modifications included more sessions (n = 202, 25.03%). CONCLUSIONS: PTS symptom severity and social support predict treatment satisfaction among racially and ethnically diverse perinatal populations and should be considered when delivering psychotherapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153864. Registered on November 6, 2019.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.009
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.005
Threshold uncertainty score0.013

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.009
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.044
GPT teacher head0.341
Teacher spread0.297 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations1
Published2025
Admission routes1
Has abstractyes

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