Advancing Insight into Maternal Social Support (AIMSS)

摘要 产后情绪障碍（PPMD）影响了8-13%的新妈妈，另有16-23%的新妈妈经历了情绪障碍。 在婴儿出生后的第一年里，PPMD有多种干预措施，包括 药物和社会心理治疗，如社会支持。然而，现有的优势研究 社会支助方案的实施仅限于产后时期。因此，社会支助的好处 怀孕期间的计划尚未建立，对怀孕期间的情况知之甚少。 这些程序可能会影响PPMD。CenteringPregnancy是一种基于小组的产前护理模式， 与常规产前护理（CAU）相比，孕产妇和婴儿的健康结果是积极的。它解决 许多障碍通常阻碍产前心理健康干预，是一种成本低，易于传播的 模型，并在不同的样本中具有较高的患者满意度。然而，记录的结果仅限于 出生结果（例如，减少早产率，减少低出生体重，增加母乳喂养）， 产前产妇的身体健康，如妊娠糖尿病和吸烟。研究结果显示， 产后心理健康的研究很少，受样本量小、缺乏产后心理健康的影响， 评估，以及心理健康结果的狭义操作化（例如，抑郁症）。拟议 该项目将通过以下目标来检查心理健康益处，以解决这些限制：1）使用 预先存在的数据集，以确定CenteringPregnancy模型与CAU模型在什么条件下会影响 产妇抑郁症的结果; 2）收集新的数据，以检查作为临床干预的影响， 产妇结局（例如，PPMD和早期养育的相互作用），同时 观察和收集关于实施的信息以便a）最大化临床功效效用（即， 关注内部有效性），并检查B）临床有效性（即，（c）执行情况 结果（即，可接受性、可行性），以促进可持续性和可扩展性， 3）加强我们的研究环境， 本科生在合作研究，同时指导和指导他们的研究概念， 过程（例如，研究方法、参与者招募、道德和专业标准、数据 收集和分析，以及学术生产力），因为它们与CenteringPregnancy模型，孕产妇 心理健康和相关结果。这项研究的结果将有助于现有的知识基础 通过提高对与孕产妇心理健康相关的社会支持干预措施的理解， 有针对性的预防和干预计划的切入点，以改变产妇情绪障碍的风险， 怀孕期间和产后期间。此外，注重临床有效性和实施 成果将支持涉及基于群体的社会支助的干预措施的可持续性和可扩展性。

ABSTRACT Postpartum mood disorders (PPMD) affect 8-13% of new mothers, with another 16-23% experiencing elevated symptomology throughout the infant’s first year of life. A variety of interventions for PPMD exist, including pharmacological and psychosocial treatments such as social support. However, existing research on advantages of social support programs has been limited to the postpartum period only. As such, benefits of social support programs during pregnancy have not been established, and little is known about the conditions under which these programs may affect PPMD. CenteringPregnancy is a group-based prenatal care model with demonstrated positive maternal and infant health outcomes when compared to prenatal care-as-usual (CAU). It addresses many barriers commonly impeding prenatal mental health interventions, is a low-cost and easily disseminated model, and has high patient satisfaction across diverse samples. However, documented outcomes are limited to birth outcomes (e.g., reduced preterm birth rates, reduced low birth-weight, increased breastfeeding) and prenatal maternal physical health such as gestational diabetes and smoking. The research examining the effect on postpartum mental health is scant and limited by small sample sizes, absence of postpartum mental health assessments, and narrow operationalization of mental health outcomes (e.g., depression only). The proposed project will address these limitations by examining mental health benefits through the following Aims: 1) Use a pre-existing dataset to determine under what conditions the CenteringPregnancy model versus CAU affects maternal depression outcomes; 2) Gather new data to examine impacts as a clinical intervention on relevant maternal outcomes (e.g., PPMD; interaction effects of PPMD and early parenting), while simultaneously observing and gathering information on implementation in order to a) maximize clinical efficacy utility (i.e., focusing on internal validity), and examine b) clinical effectiveness (i.e., generalizability), and c) implementation outcomes (i.e., acceptability, feasibility) in order to facilitate sustainability and scalability as an effective intervention and prevention strategy for PPMD; and 3) Strengthen our research environment and engage undergraduate students in collaborative research while mentoring and instructing them in research concepts and processes (e.g., research methodology, participant recruitment, ethical and professional standards, data collection and analysis, and scholarly productivity) as they relate to the CenteringPregnancy model, maternal mental health, and relevant outcomes. The results of this research will contribute to the existing knowledge base by advancing understanding of social support interventions relevant to maternal mental health and revealing targeted points of entry for prevention and intervention programs to alter maternal mood disorder risk during pregnancy and throughout the postpartum period. Further, the focus on clinical effectiveness and implementation outcomes will support sustainability and scalability of interventions involving group-based social support.