Abstract
Background
The Reproductive Mental health of Ontario Virtual Intervention Network (MOVIN) aims to improve perinatal depression care across a large Canadian health jurisdiction. It involves a web-based platform, care coordinator for personalized treatment planning, and psychiatrist to liaise with primary care clinicians, and provide direct consultation as needed. This was a pilot randomized controlled trial (RCT) of MOVIN.
Methods
Participants aged ≥18 years, pregnant or within 12 months postpartum and with Edinburgh Postnatal Depression Scale (EPDS) score >12 recruited from across Ontario, Canada, were randomized 1:1 to MOVIN for 24 weeks or a control condition. The primary outcome was feasibility, inclusive of recruitment, acceptability, and research protocol follow-up. Depression symptom remission was a main secondary outcome for the pilot trial. EPDS scores and remission (EPDS ≤ 12) were compared between groups.
Results
Of 101 participants (n = 48 MOVIN; n = 53 control), 80% completed 24-week follow-up. Participant views of MOVIN were very positive (high acceptability) and multiple opportunities for protocol adjustment in a larger future study were identified. At 24 weeks post-randomization, EPDS scores were lower in MOVIN vs. controls, with a mean difference adjusted for baseline score of −2.32 (95% Confidence Interval, CI −4.23 to −0.42). At the same time point, 75.0% of the MOVIN group vs. 51.1% of controls were in remission (chi-square=4.83, p = 0.03).
Conclusions
With high feasibility, including in recruitment, acceptability, and research protocol adherence, and preliminary suggestion of efficacy, the results of this study support proceeding to a large-scale RCT of MOVIN to definitively evaluate its efficacy at a larger scale.
Plain language summary
Depression affects up to 20% of people during and after pregnancy, but as few as 1 in 5 are treated to remission. In the Reproductive Mental health of Ontario Virtual Intervention Network (MOVIN), participants can view educational resources about depression during and after pregnancy, and receive personalized evidence-based treatment planning with a care coordinator with oversight by a psychiatrist. Automated symptom check-ins help identify when to iterate treatment plans over time. This pilot randomized controlled trial (RCT) showed that MOVIN was feasible to implement and highly acceptable to participants. After 6 months, more MOVIN participants were in remission of their depression (~75%) than were participants randomized to a usual care control condition (~51%). These results support proceeding to a larger trial to definitely evaluate the MOVIN program.
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Data availability
We are unable to make the data for this study publicly available, as participants did not specifically consent to the sharing of their data at the time of initial data collection. However, data sharing agreements may be approved for specific purposes with research ethics board approval and appropriate contractual arrangements in place. Please contact simone.vigod@wchospital.ca for inquiries. Data are stored on secure servers at Women’s College Hospital in Toronto, Ontario.
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Acknowledgements
Funding for the study was provided by the Women’s College Hospital Foundation. We also thank the Daymark Foundation for its financial support in ensuring the diversity of psychoeducational resources on the platform. The funders had no involvement in the design or conduct of the study, nor in the decision to publish the results.
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S.N.V. and A.D. designed the intervention and led the conceptualization of the study, with input from C.L.D., S.G., T.J., and N.I. S.N.V. led the conduct of the study, with substantial support from A.D., M.A., K.B., S.L.G., M.M., and V.S. S.N.V. and S.L.G. led the analysis. All authors contributed to the interpretation of the study results. S.N.V. drafted the manuscript, and all authors revised the manuscript for important intellectual contributions. All authors approved the final draft of the manuscript.
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S.V. reports royalties from UpToDate Inc. for authorship of materials related to depression and pregnancy. S.G. reports royalties from UpToDate Inc. for authorship of materials related to depression and pregnancy, the Canadian Pharmacists Association, and Norton for chapters on depression, and honoraria for presentations or writing from LifeSpeak. No other authors have competing interests to declare.
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Vigod, S.N., Dalfen, A., Dennis, C. et al. The Reproductive Mental health of Ontario Virtual Intervention Network (MOVIN): a pilot randomized controlled trial. Commun Med (2026). https://doi.org/10.1038/s43856-026-01381-4
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DOI: https://doi.org/10.1038/s43856-026-01381-4
