Doctoral Dissertation Research: Inequity, postpartum neglect, and social support impacts on stress and mental health in parents with infants in intensive care

产后新生儿重症监护病房(NICU)的父母是一个被广泛研究的人群，众所周知，他们比健康婴儿的父母更容易受到不利的身心健康后果的影响。这一博士论文研究项目探索了生物文化途径，通过这些途径，社会、经济和结构性不平等与城市儿童医院NICU中有婴儿的父母的压力和抑郁有关。通过这些途径，生物学和文化的影响相互影响，为理解跨部门不平等、社会支持资源和获得足够的医疗保健如何在美国NICU父母之间调节幸福感差异提供了关键背景，他们已经处于不良结局的高风险中。这项工作的结果直接与医院领导、护理人员和研究医院研究现场的社会工作者分享，以帮助讨论如何减少父母NICU相关的压力和改善产后心理健康结果。该项目还支持本科生指导、跨学科协作和与公众的科学参与活动。重症监护婴儿与产后抑郁症、创伤后应激障碍和妊娠相关疾病的发生率较高有关，这是因为与不良分娩结局和紧张的产后环境相关的压力增加。该项目采用比较混合的方法，包括父母调查、人种学观察和访谈以及婴儿病历数据，以更全面地了解产后NICU父母的生活经历。它探讨了与NICU相关的压力和心理健康脆弱性是如何通过社会和经济不平等来调节的，这些不平等可能影响产妇产后保健和社会支持资源的充分获得。为了评估产后NICU相关压力，该项目采用了自我报告的NICU特定应激量表，使研究人员能够了解与物理和社会NICU环境相关的关键应激源是如何导致父母产后压力的。评估社会文化和经济环境、特定背景的压力源和产后NICU父母的精神影响之间的关系，不仅对父母的健康，而且对他们早期发育期间的婴儿和未来怀孕的健康至关重要。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Postpartum neonatal intensive care unit (NICU) parents are a widely understudied population known to be more vulnerable to adverse physical and mental health outcomes than parents of healthy infants. This Doctoral Dissertation Research project explores the biocultural pathways through which social, economic, and structural inequities are associated with stress and depression among parents with infants in an urban children’s hospital NICU. These pathways, through which the effects of biology and culture impact each other, provide key context for understanding how intersectional inequities, social support resources, and access to adequate healthcare mediate differences in wellbeing among NICU parents in the United States, who are already at high risk of poor outcomes. The results of this work are shared directly with hospital leaders, nursing staff, and social workers at the study’s hospital research site to contribute to discussions of how to reduce parental NICU-related stress and improve postpartum mental health outcomes. This project also supports undergraduate mentorship, interdisciplinary collaboration, and science engagement activities with the public. Having an infant in intensive care is linked to higher rates of postpartum depression, post-traumatic stress disorder, and pregnancy-related morbidities due to the increased stress associated with adverse birth outcomes and stressful postpartum environments. This project uses a comparative mixed-methods approach including parental surveys, ethnographic observations and interviews, and infant medical record data to provide a more comprehensive view of the lived experiences of postpartum NICU parents. It explores how embodied NICU-related stress and mental health vulnerabilities are mediated through social and economic inequities that can affect adequate access to maternal postpartum healthcare and social support resources. To assess postpartum NICU-related stress, the project employs a self-reported NICU-specific stress scale that allows investigators to understand how key stressors associated with the physical and social NICU environment contribute to parental postpartum stress. Assessing the relationship between the sociocultural and economic environment, contextual-specific stressors, and mental implications for postpartum NICU parents is critical not only for the health of the parent but also for their infants during early development and the health of future pregnancies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.