Preventing postpartum depression among immigrant Latinas through a virtual group intervention

项目摘要 产后抑郁症（PPD）影响了10-20%的妇女，其中拉丁裔移民的影响尤为严重。 PPD的预防和治疗是有限的移民拉丁美洲人由于一系列的结构和文化 这些因素表明需要在传统医疗环境之外提供干预措施。虚拟 干预措施有可能减少拉丁美洲移民获得心理健康服务的障碍，但 关于虚拟干预措施减少PPD症状的有效性的研究很少。母亲和婴儿是一个 基于认知行为疗法和依恋理论的循证团体干预 目的是预防PPD。《母亲和婴儿》经过改编，通过虚拟小组形式（母亲 和婴儿虚拟组; MB-VG），试点研究表明，良好的可行性和可接受性，以及 改善拉丁裔移民的心理健康状况。建议的项目属于第1类成效- 基于PPD风险的妊娠个体和新母亲实施随机对照试验 抑郁症状升高和/或其他已确定的风险因素， 整个马里兰州的项目。共有300名妇女将参加; 150名将接受MB-VG，150名将接受 接受常规的家庭支持服务。该项目旨在评估：1）MB-VG减少 抑郁症状，预防产后抑郁症的发生，提高育儿自我效能和反应能力; 2） MB-VG的实施; 3）影响MB-VG有效性和实施的背景因素。一个 探索性的目标还将检查参与者的儿童自我调节和入学准备结果 （~N=150）有年龄在2.5-4.5岁之间的大龄儿童。经过培训的幼儿中心工作人员将提供MB-VG 会话，干预参与者使用任何电子设备通过Zoom接收虚拟组会话 （智能手机、平板电脑、笔记本电脑）。在基线、1周、3个月和6个月时进行母亲自我报告调查。 在干预后3个月和6个月进行结构化临床访谈， 干预与MB-VG促进者和接受者以及幼儿的关键线人访谈 项目负责人将提供MB-VG实施和影响环境因素的数据 实施.将通过干预会话音频的严格编码评估MB-VG输送的保真度 录音.我们的研究是第一个向拉丁移民提供虚拟PPD预防干预的研究， 评估其影响。鉴于其虚拟交付模式，MB-VG可以轻松复制和扩展到其他 家庭支持计划和设置服务移民拉丁美洲人。如果有效并得到广泛实施， 拉丁裔移民将获得心理健康服务，更少的人将遭受负面影响 与PPD有关。拟议的项目与NIMHD的高优先领域保持一致，包括开发 并测试干预措施以减少差距。

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.