# Adaptation and pilot testing of a couples-based intervention to prevent perinatal depression in rural India

> **NIH NIH K99** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $142,021

## Abstract

Project Summary
Nearly one in four women in India experience perinatal depression, which occurs during pregnancy or the
postpartum period. Preventing perinatal depression (PND) is important for the health of the mother and child as
untreated PND is associated with long-lasting consequences such as an increased risk of suicide, impaired
parenting, and adverse impacts on offspring. Dyadic or marital relationship-level risk factors such as low social
support from the husband, inequitable couples’ relationship dynamics, and unequal decision-making are
significant risk factors for perinatal depression. Couples-based interventions tested in high-income settings
focused on mutable risk factors such as couples' relationship quality and social support have been shown to be
effective in preventing perinatal depression. To date, depression interventions in low-income settings have
primarily focused on treating pregnant women who are already experiencing depression, and limited trials have
investigated preventive approaches. Further, there is a dearth of preventive trials addressing dyadic
determinants by targeting couples. The goal of this K99/R00 Pathway to Independence Award application is to
culturally adapt evidence-based intervention(s) as a couples-based intervention and conduct a pilot
randomized controlled trial to assess feasibility, acceptability, and preliminary efficacy among primiparous
(first-time pregnant) couples in rural central India. To achieve the mentored K99 phase and career transition to
an independent investigator, I have assembled a multidisciplinary mentoring team with expertise in perinatal
mental health, couples-based intervention development, implementation science and cross-cultural
intervention adaptation, and dyadic skills. During the mentored phase (K99), I will pursue the following training
and research objectives: (1) gain proficiency in dyadic data analysis with couples, (2) enhance my knowledge
of perinatal mental health, and (3) acquire expertise in implementation science. The knowledge and skills
gained in the mentored K99 phase will be instrumental in achieving the specific aims of the R00 phase, which
are to: (1) Identify primiparous couples’ needs and preferences, and barriers and facilitators to engaging
husbands, in a couples-based intervention to prevent PND; (2) Adapt evidence-based intervention(s) for
couples to improve spousal support, shared decision-making, and couples’ relationship dynamics in the
perinatal period to prevent PND; and (3) Assess the feasibility, acceptability, and preliminary efficacy of the
adapted couples-based intervention through a pilot randomized controlled trial. I will use the results of the pilot
to refine the intervention and develop an R01 proposal for a randomized controlled trial with a larger sample
and longer follow-up, to assess the impact on long-term maternal and child health outcomes. The proposed
training, and research plan in this K99/R00 application will prepare me for ...

## Key facts

- **NIH application ID:** 10864570
- **Project number:** 1K99HD114849-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Lakshmi Gopalakrishnan
- **Activity code:** K99 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $142,021
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864570

## Citation

> US National Institutes of Health, RePORTER application 10864570, Adaptation and pilot testing of a couples-based intervention to prevent perinatal depression in rural India (1K99HD114849-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10864570. Licensed CC0.

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