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Pilot Study of the Mastery Lifestyle Intervention

Ruiz, R. Jeanne; Newman, Matt; Records, Kathie; Wommack, Joel C.; Stowe, Raymond P.; Pasillas, Rebecca M.

doi: 10.1097/NNR.0000000000000384

Background Recognizing the effects of acculturation on quality of life and emotional health, especially during pregnancy, we developed an intervention that would target these factors in order to improve maternal well-being during the prenatal period and potentially improve infant outcomes, particularly preterm birth for Mexican-American women (Latinas).

Objective The purpose of these pilot studies was to test the acceptability, feasibility, and preliminary efficacy of the mastery lifestyle intervention (MLI) to decrease depressive and anxiety symptoms and improve coping as implemented in prenatal clinics with culturally homogenous groups of Latinas.

Methods The MLI was tested in three small pilot studies (n = 15), one in El Paso, Texas (an urban area), and two in Bastrop, Texas (a rural area outside Austin), for acceptability and feasibility. A pretest/posttest, quasi-experimental design was used with pregnant self-identified Mexican-American Latinas at 14–20 weeks' gestation. Measures of anxiety, depressive symptoms, and positive and negative coping were used.

Results Feasibility was a success in terms of implementation of the MLI in an active prenatal clinic setting and the use of electronic tablets for data collection and entry of data into REDcap. Satisfaction was high, with the location of the MLI being at their primary OB/GYN clinic. Participants reported that six intervention sessions appear to be ideal as was the class length of 1.5 to 2 hours. On Cohen's d, there were medium to large effect size decreases in depressive and anxiety symptoms and small to medium effect size decreases in the use of negative coping strategies and small effect sizes for increases in positive coping strategies.

Discussion Pilot testing of the MLI indicated that it was well accepted from the participants and feasible as a culturally tailored behavioral therapy administered in a group setting by nurse practitioners. Our initial pilot results also suggest preliminary efficacy as indicated by moderate to large Cohen's d effect sizes for depression and anxiety.

R. Jeanne Ruiz, PhD, WHCNP-BC, FAAN, is Professor, Microgen Laboratories, LaMarque, Texas.

Matt Newman, PhD, is President, Serenity Research & Consulting LLC, Austin, Texas.

Kathie Records, PhD, RN, FAAN, is Associate Professor, University of Northern Colorado Greeley.

Joel C. Wommack, PhD, is Professor, Microgen Laboratories, LaMarque, Texas.

Raymond P. Stowe, PhD, is Professor, Microgen Laboratories, LaMarque, Texas.

Rebecca M. Pasillas, PhD, is Research Assistant Professor, University of Texas at El Paso.

Accepted for publication March 26, 2019.

The research reported in this publication was supported by funding from Texas A&M Health Science Center College of Nursing.

This study was conducted using ethical standards of research and institutional review board approval of the study protocol from Texas A&M, College Station, Texas, as well as from Texas Tech University, El Paso, Texas.

The authors want to thank Annie Perez, PhD, CNM, and Jeffrey Hagen, MD, for their support in obtaining participants from their clinics and practices.

The authors have no conflicts of interest to disclose.

Corresponding author: R. Jeanne Ruiz, PhD, WHCNP-BC, FAAN, Microgen Laboratories, LLC 216 Pioneer Passage, Bastrop, TX 78602 (e-mail:

Online date: August 8, 2019

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