RESEARCH DESIGN & METHODS RESULTS CONCLUSIONS INTRODUCTION ACKNOWLEDGEMENTS IMPLICATIONS FOR PRACTICE The Effects of Guided Imagery in Reducing Stress in Pregnant Adolescents Brittney Jones, OTS & Karla Ausderau, PhD, OTR Occupational Therapy Program, Department of Kinesiology- University of Wisconsin-Madison A Special Thanks To: My research mentor, Dr. Karla Ausderau My wonderful research teammates: Carlie Borhman, Lindsay Brooks, and Leanna Linzell The SAPAR staff and participants, Terri Flynn and the Gertrude E. Gatson Fund Dr. Mary Schneider and the OT faculty and staff And to my family, friends, and classmates for their support Prolonged stress can lead to adverse psychological and physical effects for both the mother and developing child (Keller et al., 2012) Teen mothers are at an increased risk of medical complications during pregnancy because of stress (American Academy of Children & Adolescent Psychiatry, 2012) High rate of teen pregnancy and the long-term cost to individuals as well as society elevates the need for evidence –based interventions for stress management Guided Imagery (GI) is a promising prevention strategy to manage stress in adult pregnant women (Jallo et al, 2008) Purpose Investigate the effectiveness of using Guided Imagery for reducing perceived stress experienced among pregnant adolescents Hypothesis GI intervention will reduce stress levels Level of stress significantly decreased over time, p =.001, Partial eta squared = .71 Fig 1 Stress level significantly decreased between Session 1 & all other Sessions (Session 2 [p = .002] Session 3 [p < .001], & Session 4 [p = .002]). Remaining pairwise comparisons did not differ. Figure 1. PSM-9 Pre-test and Posttest Scores PSM-9 mean post-test scores were significantly lower than mean pretest scores (paired-samples t-test, p <.001. Pre-test (M = 29.44, [SD = 10.20]), Posttest (M = 21.41, [SD = 7.09]), Fig. 2 Figure 2. Mean PSM-9 Pre-test and Posttest Scores for all 4 Sessions Guided imagery lowered stress levels in pregnant adolescents; after an initial improvement in stress, subsequent reductions were stable Average PSM-9 posttest scores from 4 GI sessions were lower than pretest scores, a second indication that GI reduces stress in pregnant teens Explore intervention intensity in future studies to determine maximal benefit of GI Early detection of highly stressed and anxious pregnant women may be the key in reducing prenatal stress complications. Intervention programs that provide specific information and education, should also emphasize relaxation methods for pregnant women at increased risks of stress, including pregnant adolescents Occupational Therapists (OT) are experts in lifestyle redesign Preventative OT lifestyle redesign programs for pregnant adolescents should: incorporate GI into their daily lives, focus on reducing stress and removing environmental stressors, and teach teens effective stress management strategies in order to promote and maintain health. Participants 17 pregnant adolescents Ages 14-19 (M =16.53, [SD = 1.33]) In School-Age Parent Program MMSD Design and Intervention Quasi-experimental design Repeated measure design was used to test for difference in stress over 4 GI sessions Participants were given an MP3 player with a 12 minute & 51 second GI audio recording Measures Psychological Stress Measure (PSM- 9) 9-item questionnaire to measure perceived level of stress, Likert style scale Pretest and posttest before and

RESEARCH DESIGN & METHODS RESULTS CONCLUSIONS INTRODUCTION ACKNOWLEDGEMENTS IMPLICATIONS FOR PRACTICE The Effects of Guided Imagery in Reducing Stress

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RESEARCH DESIGN & METHODS

RESULTS

CONCLUSIONSINTRODUCTION

ACKNOWLEDGEMENTS

IMPLICATIONS FOR PRACTICE

The Effects of Guided Imagery inReducing Stress in Pregnant Adolescents

Brittney Jones, OTS & Karla Ausderau, PhD, OTROccupational Therapy Program, Department of Kinesiology- University of Wisconsin-Madison

A Special Thanks To:My research mentor, Dr. Karla AusderauMy wonderful research teammates: Carlie Borhman, Lindsay Brooks, and Leanna LinzellThe SAPAR staff and participants, Terri Flynn and the Gertrude E. Gatson Fund Dr. Mary Schneider and the OT faculty and staffAnd to my family, friends, and classmates for their support

Prolonged stress can lead to adverse psychological and physical effects for both the mother and developing child (Keller et al., 2012)

Teen mothers are at an increased risk of medical complications during pregnancy because of stress (American Academy of Children &

Adolescent Psychiatry, 2012)

High rate of teen pregnancy and the long-term cost to individuals as well as society elevates the need for evidence –based interventions for stress management

Guided Imagery (GI) is a promising prevention strategy to manage stress in adult pregnant women (Jallo et al, 2008)

Purpose Investigate the effectiveness of using Guided

Imagery for reducing perceived stress experienced among pregnant adolescents

Hypothesis GI intervention will reduce stress levels

Level of stress significantly decreased over time, p =.001, Partial eta squared = .71 Fig 1

Stress level significantly decreased between Session 1 & all other Sessions (Session 2 [p = .002] Session 3 [p < .001], & Session 4 [p = .002]). Remaining pairwise comparisons did not differ.

Figure 1. PSM-9 Pre-test and Posttest Scores

PSM-9 mean post-test scores were significantly lower than mean pretest scores (paired-samples t-test, p <.001. Pre-test (M = 29.44, [SD = 10.20]), Posttest (M = 21.41, [SD = 7.09]), Fig. 2

Figure 2. Mean PSM-9 Pre-test and Posttest Scores for all 4 Sessions

Guided imagery lowered stress levels in pregnant adolescents; after an initial improvement in stress, subsequent reductions were stable

Average PSM-9 posttest scores from 4 GI sessions were lower than pretest scores, a second indication that GI reduces stress in pregnant teens

Explore intervention intensity in future studies to determine maximal benefit of GI

Early detection of highly stressed and anxious pregnant women may be the key in reducing prenatal stress complications. Intervention programs that provide specific information and education, should also emphasize relaxation methods for pregnant women at increased risks of stress, including pregnant adolescents

Occupational Therapists (OT) are experts in lifestyle redesign

Preventative OT lifestyle redesign programs for pregnant adolescents should: incorporate GI into their daily lives, focus on reducing stress and removing environmental stressors, and teach teens effective stress management strategies in order to promote and maintain health.

Participants17 pregnant adolescents

Ages 14-19 (M =16.53, [SD = 1.33]) In School-Age Parent Program MMSD

Design and InterventionQuasi-experimental design Repeated measure design was used to test for difference in stress over 4 GI sessions Participants were given an MP3 player with a 12 minute & 51 second GI audio recordingMeasuresPsychological Stress Measure (PSM-9)

9-item questionnaire to measure perceived level of stress, Likert style scale

Pretest and posttest before and after each GI session, difference scores analyzed

Data AnalysisOne-way repeated measures ANOVA and paired-samples t-test