An Internet-Delivered Mind-Body Program for Reducing Prenatal Maternal Stress

一项通过互联网提供的身心计划，用于减轻产前母亲的压力

• 批准号: 10471851
• 负责人: Brittain Lynn Mahaffey
• 金额: $ 14.04万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471851
• 关键词: Address; Adherence; Aftercare; Anxiety; Area; Arousal; Behavior Therapy; Behavioral; Birth; Caring; Child; Child Health; Chronic; Cognitive Therapy; Complex; Data; Development; Distress; Doctor of Philosophy; Eligibility Determination; Enrollment; Evidence based intervention; Fetal Development; Fetal health; Focus Groups; Goals; Grant; Guidelines; Health; Health Benefit; Health Services Accessibility; Health behavior; Healthcare; Infant; Infant Mortality; Internet; Intervention; Interview; Learning; Longevity; Low Birth Weight Infant; Major Depressive Disorder; Maternal Health; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Mind-Body Intervention; Modality; Modification; Morbidity - disease rate; Outcome; Participant; Perinatal; Perinatology; Persons; Phase; Population; Population Programs; Postpartum Period; Pregnancy; Pregnant Women; Premature Birth; Prevention; Program Development; Protocols documentation; Psychopathology; Psychosocial Factor; Randomized; Randomized Clinical Trials; Regulation; Relaxation; Research; Risk; Risk Factors; Social support; Stress; Stressful Event; Sympathetic Nervous System; Symptoms; Techniques; Technology; Testing; Training; Training Programs; Videoconferencing; Woman; Women' s Health; Work; Yoga; barrier to care; base; behavioral health intervention; body-mind; career development; cognitive change; coping; depressive symptoms; efficacy testing; evidence based guidelines; experience; improved; innovation; maternal stress; medication safety; mindfulness meditation; multidisciplinary; multimodality; negative affect; patient oriented; patient oriented research; perceived stress; perinatal health; perinatal intervention; perinatal mental health; physical conditioning; pilot trial; preference; prenatal; prenatal intervention; programs; response; screening; social stigma; stress management; stress resilience; stress symptom; treatment adherence; treatment as usual

Project Summary. Prenatal Maternal Stress (PNMS) is commonly defined as the combination of stressful life-events, elevated perceived stress, pregnancy-specific stress, and symptoms of depression and anxiety. It is a well-established risk factor for preterm delivery and low birth-weight, both of which are leading causes of infant mortality, mor- bidity and chronic health problems. It is also one of the most robust predictors of postpartum maternal mental health problems. Despite this, PNMS often remains untreated due to inadequate screening, concerns about medication safety, stigma, practical barriers accessing care, and a lack of evidence based interventions. Thus, there is a critical need for the development of comprehensive interventions for PNMS that are accessible to women during pregnancy. The long-term goal of this K 23 proposal is to build a program of research focused on methods for treating PNMS that have demonstrable mental and physical health benefits for woman and children. The overall objective of this application is to evaluate the feasibility (primary aim), acceptability and preliminary efficacy (secondary aims) of the SMART-Pregnancy Program a multimodal CBT-based mind-body intervention for PNMS delivered via videoconferencing. Behavioral intervention technologies such as videocon- ferencing can minimize practical barriers to accessing care. The specific aims are: Phase 1 Program Devel- opment: Aim 1: We will identify treatment needs and preferences, barriers to treatment engagement and ap- propriate countermeasures using a focus group approach (N = 6 groups, 6-8 per group). Data will be synthe- sized and used to develop the online SMART-Pregnancy Program. Aim 2: We will refine and finalized treat- ment modifications by conducting an open pilot of the SMART-Pregnancy protocol via online videoconferenc- ing (N = 8). Exit interviews will be used to assess accessibility, goodness of fit to needs, and barriers to en- gagement and adherence. Phase 2: Program Feasibility: Aim 1 (primary): We will examine the feasibility of conducting an RCT in which women with elevated PNMS are randomized to an online SMART-Pregnancy group (n=30) or treatment as usual (TAU; n=30). We will evaluate rates of eligibility, enrollment, and retention. We predict > 75% retention through all 3 study follow-ups. Aim 2 (secondary): We will collect data on treat- ment adherence (# of sessions attended) and preliminary efficacy. We predict that SMART-Pregnancy partici- pants will attend >75% of online sessions and will display greater reductions in distress and improvements in stress regulation at post-treatment than TAU. We will also explore treatment impact on maternal health and delivery outcomes. Career development goals include: developing expertise in perinatal stress and mental health, learning mixed-methods techniques for optimizing interventions, and gaining experience in the assess- ment of perinatal health and birth outcomes. A multidisciplinary team of leading experts in perinatal stress (Marci Lobel PhD), perinatology (David Garry DO, MFM), mind-body medicine, and mixed-methods (Elyse R. Park PhD, MPH), and grantsmanship/RCT implementation (Adam Gonzalez PhD) will provide mentorship.

项目摘要。 产前母亲应激(PNMS)通常被定义为应激性生活事件的组合， 感受到的压力、妊娠特有的压力以及抑郁和焦虑的症状。这是一个久负盛名的 早产和低出生体重的风险因素，这两个都是婴儿死亡的主要原因，更 疾病和慢性健康问题。它也是产后母亲心理状态最可靠的预测指标之一 健康问题。尽管如此，PNMS往往由于筛查不充分而得不到治疗，对 用药安全、耻辱、获得医疗服务的实际障碍以及缺乏循证干预措施。因此， 迫切需要为PNMS制定全面的干预措施，以便 怀孕期间的妇女。这项K23提案的长期目标是建立一个以研究为重点的计划 关于对妇女和妇女的身心健康有明显益处的经前非典型肺炎的治疗方法 孩子们。本申请的总体目标是评估可行性(主要目标)、可接受性和 智能妊娠计划的初步效果(次级目标)基于多模式CBT的心身 通过视频会议提供对PNMS的干预。行为干预技术，如视频监控- 会诊可以最大限度地减少获取医疗服务的实际障碍。具体目标是：第一阶段计划开发- 行动：目标1：我们将确定治疗需求和偏好、治疗参与的障碍和AP- 使用焦点小组方法(N=6组，每组6-8个)选择适当的对策。数据将被合成- 确定大小并用于开发在线智能怀孕程序。目标2：我们将完善和最终确定治疗- 通过在线视频会议进行智能怀孕方案的公开试点，以进行修改-- ING(N=8)。离职面谈将被用来评估可访问性、符合需求的程度以及进入- 凝聚和坚守。阶段2：计划可行性：目标1(主要)：我们将研究 进行随机对照试验，将PNMS升高的妇女随机分为在线智能妊娠组 对照组(n=30)或常规治疗组(n=30)。我们将评估资格率、招生率和保留率。 通过所有3项研究的随访，我们预测&gt；75%的保留率。目标2(次要)：我们将收集有关治疗的数据- 服药依从性(出席会议次数)和初步效果。我们预测聪明怀孕的人- 裤子将参加75%的在线课程，并将显示出更大的减少痛苦和改善 治疗后应激调节优于TAU。我们还将探讨治疗对产妇健康的影响和 分娩结果。职业发展目标包括：发展围产期压力和精神方面的专门知识 健康，学习优化干预措施的混合方法技术，并在评估中获得经验- 围产期健康和出生结局的评估。由围产期应激方面的顶尖专家组成的多学科团队 (Marci Lobel博士)，围产科学(David Garry Do，MFM)，心身医学和混合方法(Elyse R. Park博士、公共卫生硕士)和Grantsering/RCT Implementation(Adam Gonzalez博士)将提供指导。

项目成果

Adverse Perinatal Outcomes Predicted by Prenatal Maternal Stress Among U.S. Women at the COVID-19 Pandemic Onset.

• DOI: 10.1093/abm/kaab005
• 发表时间: 2021-03-20
• 期刊: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
• 作者: Preis H;Mahaffey B;Pati S;Heiselman C;Lobel M
• 通讯作者: Lobel M

The German version of the pandemic-related pregnancy stress scale: A validation study.

• DOI: 10.1016/j.ejogrb.2020.10.062
• 发表时间: 2021-01
• 期刊: European journal of obstetrics, gynecology, and reproductive biology
• 作者: Schaal NK;Marca-Ghaemmaghami P;Preis H;Mahaffey B;Lobel M;Amiel Castro R
• 通讯作者: Amiel Castro R

Development and psychometric properties of the Pandemic-Related Postpartum Stress Scale (PREPS-PP).

• DOI: 10.1080/0167482x.2021.2013798
• 发表时间: 2022-12
• 期刊: JOURNAL OF PSYCHOSOMATIC OBSTETRICS & GYNECOLOGY
• 影响因子: 3.1
• 作者: Levinson, Amanda;Mahaffey, Brittain;Lobel, Marci;Preis, Heidi
• 通讯作者: Preis, Heidi

"How am I going to make it through pregnancy?" A qualitative examination of prenatal maternal stress.

• DOI: 10.1111/birt.12598
• 发表时间: 2022-06
• 期刊: BIRTH-ISSUES IN PERINATAL CARE
• 影响因子: 2.5
• 作者: Mahaffey, Brittain L.;Tilley, Jacqueline L.;Molina, Lucero K.;Gonzalez, Adam;Park, Elyse;Lobel, Marci
• 通讯作者: Lobel, Marci

Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance.

• DOI: 10.1111/papt.12418
• 发表时间: 2022-12
• 期刊: PSYCHOLOGY AND PSYCHOTHERAPY-THEORY RESEARCH AND PRACTICE
• 影响因子: 3.4
• 作者: Tilley, Jacqueline L.;Molina, Lucero;Luo, Xiaochen;Natarajan, Aaradhana;Casolaro, Leslye;Gonzalez, Adam;Mahaffey, Brittain
• 通讯作者: Mahaffey, Brittain