Browsing by Author "Franco, Pamela"
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Publication “How it is said”: Analyses of WhatsApp communications in a postpartum depression preventive intervention(2024) Fernández, Olga; Pérez, J. Carola; Alamo, Nicole; Fernández, Sofía; Franco, Pamela; Coo, Soledad; García Valdés, María Ignacia; Aravena, MarcelaIntroduction: “m-What Were We Thinking” (m-WWWT) is an m-health, intervention oriented to prevent symptoms of postpartum depression and anxiety in first-time mothers. Mothers receive psychoeducation and socioemotional support through written communication via text-messaging (i.e., WhatsApp) with the program counsellor. Although the use of m-health interventions targeting mental health has increased, the form/style of communication through text messages between participants and program counsellors has been understudied. Objective: The aim was to describe the formal structure of the communication (Basic Forms) and the communicational intentions (Communicative Intentions) used in the messages sent by the counsellor and to determine if these are related to the post-intervention outcomes. Methods: 438 text messages sent by the counsellor to 53 first-time mothers (M = 25.32 years, SD = 4.23) who participated in the m-WWWT intervention were analyzed. The Therapeutic Activity Coding System was used to capture the communication as a “Communicative Action”. Results: The study highlighted the counsellor's frequent use of the “assertion” communicative form (82%) and attuned communicative intentions (52%) and explored (39%) in her messages. The attractors of communication were “assert to attune” and “assert to explore”, indicating an empathetic and informative communication style. With respect to their relationship with the intervention outcome, only “assert to explore” messages were positively related to maternal self-efficacy increases. The number of messages was not associated with participants’ characteristics at baseline, except for educational level. Discussion: Our results show the relevance of combining the delivery of information with a communication style that allows the counsellor to connect with the specific needs and emotional tone of the participants.Publication Interpretable machine learning model for characterizing magnetic susceptibility-based biomarkers in first episode psychosis(2025) Franco, Pamela; Montalba, Cristian; Caulier, Raúl; Milovic, Carlos; González, Alfonso; Ramirez, Juan; Undurraga, Juan; Salas, Rodrigo; Crossley, Nicolás; Tejos, Cristian; Uribe, SergioBackground and purpose: Several studies have shown changes in neurochemicals within the deep-brain nuclei of patients with psychosis. These alterations indicate a dysfunction in dopamine within subcortical regions affected by fluctuations in iron concentrations. Quantitative Susceptibility Mapping (QSM) is a method employed to measure iron concentration, offering a potential means to identify dopamine dysfunction in these subcortical areas. This study employed a random forest algorithm to predict susceptibility features of the First-Episode Psychosis (FEP) and the response to antipsychotics using Shapley Additionality Explanation (SHAP) values. Methods: 3D multi-echo Gradient Echo (GRE) and T1-weighted GRE were obtained in 61 healthy-volunteers (HV) and 76 FEP patients (32 % Treatment-Resistant Schizophrenia (TRS) and 68 % treatment-Responsive Schizophrenia (RS)) using a 3T Philips Ingenia MRI scanner. QSM and R2* were reconstructed and averaged in twenty-two segmented regions of interest. We used a Sequential Forward Selection as a feature selection algorithm and a Random Forest as a model to predict FEP patients and their response to antipsychotics. We further applied the SHAP framework to identify informative features and their interpretations. Finally, multiple correlation patterns from magnetic susceptibility parameters were extracted using hierarchical clustering. Results: Our approach accurately classifies HV and FEP patients with 76.48 ± 10.73 % accuracy (using four features) and TRS vs RS patients with 76.43 ± 12.57 % accuracy (using four features), using 10-fold stratified cross-validation. The SHAP analyses indicated the top four nonlinear relationships between the selected features. Hierarchical clustering revealed two groups of correlated features for each study. Conclusions: Early prediction of treatment response enables tailored strategies for FEP patients with treatment resistance, ensuring timely and effective interventions.Publication Online Intervention Targeting Postnatal Depression and Anxiety in Chilean First-Time Mothers: Feasibility Trial(2024) Coo, Soledad; García Valdés, María Ignacia; Pérez, J. Carola; Aldoney, Daniela; Olhaberry, Marcia; Fernández, Olga; Alamo, Nicolle; Franco, Pamela; Pérez, Francisca; Fernández, Sofía; Fisher, Jane; Rowe, HeatherObjective: Internet-based interventions may positively impact maternal symptoms of postnatal depression and anxiety. This study assessed the feasibility, acceptability, perceived usefulness, and preliminary effectiveness of an m-Health version of “What Were We Thinking?” (m WWWT). Methods: A mixed-methods with a 2-arm randomized parallel design was used. From a total of 477 women, 157 met the inclusion criteria. 128 f irst-time mothers of full-term infants, aged 4–10weeks, who received health care at primary public health centers in Chile, were randomly assigned to the experimental (EG, n¼65) or control (CG, n¼63) groups; data of 104 of them (53 and 51, respectively) was analyzed. We used percentages and rates to measure feasibility outcomes and mixed analysis of variance (ANOVA) and latent class analyses (LCA) to assess pre liminary effectiveness. Participants completed questionnaires on mental health, social support, and maternal self-efficacy upon recruitment and 3months after completing the intervention. For the qualitative component, 12 women from the EG were interviewed. Results: Quantitative results show good feasibility outcomes, such as high recruitment (82%), low attrition (EG ¼ 12% and CG¼17%), and high follow-up (EG ¼ 97% and CG¼91%) rates. Qualitative results indicate high acceptability and perceived usefulness of m-WWWT. Mixed ANOVA did not show significant differences between the groups (all p >.05). However, multinomial regression analysis in LCA showed that womenwithlow baseline symptoms of depression and anxiety benefit from the intervention (B¼0.43, 95% confidence interval 1.09–2.16). Conclusion: m-WWWT is feasible to be implemented in Chile; future studies are needed to assess the intervention’s effectiveness.Item Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial(2022) Pérez Ewert, J. Carola; Aldoney, Daniela; García, María I.; Olhaberry, Marcia; Fernández, Olga; Alamo, Nicolle; Franco, Pamela; Pérez, Francisca; Fisher, Jane; Rowe, Heather; Coo, SoledadSymptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an under-studied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.