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）的父母是一个广泛研究不足的人群，已知比健康婴儿的父母更容易受到不良身心健康结果的影响。这个博士论文研究项目探讨了生物文化途径，通过该途径，社会，经济和结构性的不平等与城市儿童医院新生儿重症监护室中婴儿父母的压力和抑郁症有关。通过这些途径，生物学和文化的影响相互影响，为理解交叉不平等，社会支持资源和获得足够的医疗保健提供了关键背景，这些途径介导了美国NICU父母之间的福祉差异，他们已经处于不良结局的高风险之中。这项工作的结果直接与医院领导，护理人员和社会工作者在研究的医院研究现场分享，以促进如何减少父母NICU相关压力和改善产后心理健康结果的讨论。该项目还支持本科生导师，跨学科合作和科学参与活动与公众。婴儿在重症监护中与产后抑郁症，创伤后应激障碍和妊娠相关疾病的发病率较高有关，这是由于与不良分娩结果和产后压力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，以提供产后NICU父母的生活经验的更全面的看法。它探讨了如何体现NICU相关的压力和心理健康的脆弱性是通过社会和经济不平等，可能会影响产妇产后保健和社会支持资源的充分获取介导。为了评估产后NICU相关压力，该项目采用了自我报告的NICU特定压力量表，使研究人员能够了解与NICU物理和社会环境相关的关键压力源如何导致父母产后压力。评估社会文化和经济环境、特定背景的压力源之间的关系，这一奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查进行评估，被认为值得支持的搜索.

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.