Preventing postpartum depression among immigrant Latinas through a virtual group intervention

通过虚拟团体干预预防拉丁美洲移民产后抑郁症

• 批准号: 10503930
• 负责人: Rheanna Edith Platt
• 金额: $ 71.09万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-18 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10503930
• 关键词: Address; Adoption; Advisory Committees; Affect; Area; Cellular Phone; Characteristics; Child; Child Rearing; Clinical; Code; Cognitive Therapy; Communities; Consolidated Framework for Implementation Research; Counseling; Data; Discrimination; Effectiveness; Electronics; Emotions; Enrollment; Ethnic group; Evidence based intervention; Exhibits; Future; Immigrant; Impairment; Individual; Informal Social Control; Insurance; Interpersonal Relations; Intervention; Interview; Language; Latin American; Latina Population; Learning; Maintenance; Maryland; Measures; Mental Depression; Mental Health; Mental Health Services; Methods; Modality; Mothers; National Institute on Minority Health and Health Disparities; Outcome; Participant; Patient Self-Report; Perinatal; Persons; Pilot Projects; Population; Postpartum Depression; Poverty; Preventive service; Provider; Randomized Controlled Trials; Reach Effectiveness Adoption Implementation and Maintenance; Readiness; Reporting; Research; Resources; Risk; Risk Factors; Role; Schools; Self Efficacy; Series; Services; Site; Social Network; Social support; Strategic Planning; Stress; Structure; Surveys; Tablets; Testing; Text Messaging; Training; Trauma; United States; Woman; acceptability and feasibility; aged; base; contextual factors; depression prevention; depressive symptoms; disparity reduction; dosage; early childhood; effectiveness-implementation RCT; evidence base; experience; family support; food insecurity; group intervention; health care settings; implementation determinants; implementation outcomes; implementation process; implementation science; implementation strategy; improved; informant; intervention delivery; intervention effect; intervention participants; laptop; mood regulation; multidisciplinary; perinatal women; pilot test; post intervention; postnatal; pregnant; prevent; preventive intervention; programs; racial and ethnic; service providers; skills; social health determinants; social stigma; theories; therapy design; virtual; virtual delivery; virtual intervention; virtual platform

PROJECT SUMMARY Postpartum depression (PPD) affects 10-20% of women, with immigrant Latinas disproportionately affected. PPD prevention and treatment is limited among immigrant Latinas due to an array of structural and cultural factors, suggesting the need to deliver interventions outside of traditional healthcare settings. Virtual interventions have the potential to reduce barriers to mental health services for immigrant Latinas, but there is little research on the effectiveness of virtual interventions to reduce PPD symptoms. Mothers and Babies is an evidence-based group intervention based on principles of cognitive-behavioral therapy and attachment theory aimed at PPD prevention. Mothers and Babies was adapted for delivery via a virtual group format (Mothers and Babies Virtual Group; MB-VG), with a pilot study suggesting good feasibility and acceptability as well as improved mental health outcomes for immigrant Latinas. The proposed project is a Type 1 Effectiveness- Implementation randomized controlled trial among pregnant individuals and new mothers at risk for PPD based on elevated depressive symptoms and/or other established risk factors who are enrolled in early childhood programs across Maryland. A total of 300 women will be enrolled; 150 will receive MB-VG while 150 will receive usual family support services. The project aims to evaluate: 1) the effectiveness of MB-VG to reduce depressive symptoms, prevent onset of PPD, and improve parenting self-efficacy and responsiveness; 2) implementation of MB-VG; and 3) contextual factors influencing MB-VG effectiveness and implementation. An exploratory aim will also examine child self-regulation and school readiness outcomes among participants (~N=150) who have older children aged 2.5-4.5 years. Trained early childhood center staff will deliver MB-VG sessions, with intervention participants receiving virtual group sessions via Zoom using any electronic device (smartphone, tablet, laptop). Maternal self-report surveys are conducted at baseline, 1 week, 3 months, and 6 months post-intervention, with structured clinical interviews also conducted at 3- and 6-months post- intervention. Key informant interviews with MB-VG facilitators and recipients, as well as early childhood program directors will provide data on MB-VG implementation and contextual factors influencing implementation. Fidelity of MB-VG delivery will be assessed via rigorous coding of intervention session audio recordings. Our study is the first to deliver a virtual PPD preventive intervention to immigrant Latinas and to evaluate its impact. Given its virtual delivery modality, MB-VG can be easily replicated and scaled to other family support programs and settings serving immigrant Latinas. If effective and implemented broadly, more immigrant Latinas will receive mental health services and fewer will suffer the negative consequences associated with PPD. The proposed project is aligned with NIMHD’s high priority areas, including developing and testing interventions to reduce disparities.

项目摘要 产后抑郁症（PPD）影响10-20％的妇女，移民拉丁裔受到不成比例的影响。 由于一系列结构和文化，在移民拉丁裔中，PPD预防和治疗受到限制 因素，表明需要在传统医疗机构之外提供干预措施。虚拟的 干预措施有可能减少移民拉丁裔精神卫生服务的障碍，但有 关于虚拟干预措施减少PPD症状的有效性的很少的研究。母亲和婴儿是 基于循证的小组干预基于认知行为疗法和依恋理论的原则 针对预防PPD。母亲和婴儿被改编为通过虚拟组格式分娩（母亲 和婴儿虚拟组； MB-VG），通过一项试点研究，提出了良好的可行性和可接受性以及 改善了移民拉丁裔的心理健康结果。拟议的项目是1型有效性 - 孕妇和有PPD风险的新母亲的实施随机对照试验 关于早期入学的抑郁症状和/或其他已建立的危险因素 马里兰州的计划。共有300名妇女将入学； 150将获得MB-VG，而150将 接收常规的家庭支持服务。该项目旨在评估：1）MB-VG的有效性减少 抑郁症状，防止PPD发作，并改善育儿自我效能和反应能力； 2） MB-VG的实施； 3）上下文因素会影响MB-VG的有效性和实施。一个 探索目的还将检查参与者的儿童自我调节和学校准备成果 （〜n = 150）年龄较大的2.5-4.5岁的孩子。训练有素的幼儿中心工作人员将提供MB-VG 会议，干预参与者使用任何电子设备通过缩放接受虚拟组会话 （智能手机，平板电脑，笔记本电脑）。孕产妇自我报告调查是在基线，1周，3个月和6日进行的 干预后几个月，在3个月和6个月后进行结构化临床访谈。 干涉。 MB-VG促进者和收件人以及童年的主要线人访谈 计划主管将提供有关MB-VG实施和上下文因素影响的数据 执行。 MB-VG交付的保真度将通过严格的干预会话音频进行评估 录音。我们的研究是第一个向移民拉丁裔提供虚拟PPD预防性干预的研究 评估其影响。鉴于其虚拟交付方式，MB-VG可以轻松复制并缩放到其他 为移民拉丁裔提供服务的家庭支持计划和环境。如果有效和实施，更多 移民拉丁裔将获得精神卫生服务，而更少的负面后果将遭受负面影响 与PPD相关。拟议的项目与NIMHD的高优先级领域保持一致，包括开发 和测试干预措施以减少分布。