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Furthermore, the majority of these women do not receive treatment because of inadequate screening, mental health stigma, and lack of access to mental health care professionals. The purpose of this study was to evaluate the 6\u2010week and 6\u2010month postpartum effects of the Creating Opportunities for Personal Empowerment (COPE)\u2010Pregnancy (COPE\u2010P) program, administered by midwives, compared with a health promotion education program on mental health and healthy lifestyle behaviors and beliefs of Black and Hispanic women experiencing depression, anxiety, or stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was a longitudinal, 2\u2010group randomized controlled trial with 299 Black and Hispanic participants who screened high on depression, anxiety, or stress scales. In total, 41% of women screened met study eligibility criteria. Two 6\u2010session group prenatal care interventions\u2014the COPE\u2010P cognitive\u2010behavioral skills\u2010building (CBSB) program and a health promotion with discussion attention control\u2014were evaluated. Valid and reliable measures included the General Anxiety Disorder\u20107 scale, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Healthy Lifestyle Beliefs Scale, and Healthy Lifestyle Behaviors Scale, which were assessed at baseline, postintervention, 6 weeks postpartum, and 6 months postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two\u2010way analyses of variance and longitudinal multilevel growth models assessed outcomes. Both groups demonstrated rapid, significant decreases in depression, anxiety, and stress (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001) over time through 6 months postpartum. Only the COPE\u2010P group's significant improvement in healthy lifestyle behaviors was sustained through 6 weeks postpartum (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Participants who completed more CBSB activities showed greater improvements in outcomes than all other participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>CBSB and health promotion content provided in group prenatal care by midwives decreased depression, anxiety, and stress that persisted through 6 months postpartum. CBSB programming sustained longer\u2010term improvements in healthy lifestyle beliefs and behaviors. Performing more CBSB activities led to greater improvements in outcomes. The study was registered at the US National Institutes of Health (ClinicalTrials.gov) (NCT03416010).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jmwh.70154","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:40:08Z","timestamp":1782276008000},"page":"808-819","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Postpartum Mental Health and Healthy Lifestyle Behaviors in Women of Color Who Are Pregnant and Experiencing Depression, Anxiety, and Stress Through Group Prenatal Care: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"71","author":[{"given":"Bernadette Mazurek","family":"Melnyk","sequence":"first","affiliation":[{"name":"College of Nursing The Ohio State University  Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Gennaro","sequence":"additional","affiliation":[{"name":"William F. 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