Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Shih-Yu Lee, PhD, RNC--Committee Chair

Second Advisor

Sandra Hewel, PhD, WHNP-BC

Third Advisor

Frances McCarty, PhD


Postpartum Depression (PPD) is diagnosed in nearly 16% of mothers, yet more women may report symptoms of this mood disorder. Research has focused on assessment and intervention for women considered at risk for PPD while women described as low-risk are potentially overlooked. The purposes of the two-phase study were to describe the depressive symptoms among healthy, low-risk women at 4-8 weeks postpartum, determine the influence from personal characteristics, perceived stress, sleep disturbances, and fatigue to depressive symptoms (Phase I), and pilot test a stroller-walking intervention in Phase II. Women who scored above the median score from the Edinburgh Postnatal Depression Scale at baseline were eligible to enroll in a second phase. Phase II was a pilot test examining the effects of a 6-week stroller-walking intervention, three days per week for at least 30 minutes per session, on depressive symptomatology and well-being during the first three months postpartum.

A total of 62 women participated in Phase I of the study, with 11 of the women being eligible for Phase II. Among those eligible, six women enrolled in Phase II where three women randomized to the control group and three to the intervention group.

Study participants were predominantly married, Caucasian mothers from the upper income level. Findings showed normal parenting stress, but 48% of participants perceived clinically significant global stress. Mothers reported clinically significant poor sleep quality, and those with increased sleep disturbance had greater depressive symptoms and fatigue. Perceived stress, sleep disturbance, fatigue, and caesarean section delivery method accounted for 45% of the variation in depressive symptoms, and stress was the single statistically significant predictor. Phase II participants had improvement of depressive symptoms following the intervention, and intervention participants recorded daily step counts notably higher than control participants.

Future research should further explore the relationship of activity and depressive symptoms and the use of stroller walking as a preventative intervention for PPD. Endeavors need to focus not only on the depressive symptoms but also the accompanying conditions of increased stress, sleep disturbance, and fatigue among all postpartum women.