Developing a Community Singing-Based Intervention for Perinatal Mental Health in The Gambia

在冈比亚制定基于社区歌唱的围产期心理健康干预措施

• 批准号: MC_PC_MR/R024618/1
• 负责人: Lauren Stewart
• 金额: $ 19.72万
• 依托单位: Goldsmiths University of London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MC_PC_MR%2FR024618%2F1
• 关键词: Developing; Community; Singing; Based; Intervention

Perinatal mental health problems affect up to 1 in 5 women worldwide. Stress, anxiety and depression in pregnancy affects not only the mother but can also have long-term adverse effects on her child, via biological mechanisms in utero. Postnatal depression can reduce her ability to provide sensitive and responsive caregiving, and this can also impair child development. Mental health problems in the perinatal period are a particular challenge in low and middle-income countries (LMICs) where they can be at least twice as frequent as in higher income countries. Our geographical context for this work will be The Gambia, West Africa, where mental health services are minimal, services for perinatal mental health are non-existent and high levels of stigma associated with mental health issues, as well as specific local attitudes and beliefs, impede recognition and prevent help-seeking behaviour. It is thus of high priority to develop new low-cost, low-resource, non-stigmatising and culturally appropriate approaches to reduce symptoms of anxiety and depression perinatally, for the benefit of both mother and child. The current project suggests that the creative arts - in particular group singing - could show special promise in alleviating perinatal mental distress in The Gambia. In developed countries, such as the UK and the USA, singing in groups has been shown to be a powerful modulator of mood and emotion, evoking positive effects on mental health, well-being and social affiliation via well-attested mechanisms involving synchrony, entrainment and hormonal effects. Music-centred approaches may be particularly fruitful to apply in The Gambia, since there already exist a range of musical practices that specifically engage pregnant women and new mothers. For instance, infant naming ceremonies occur 7 days after birth and are musical celebrations to recognise the new mother and her family, and performances by Kanyeleng groups are closely associated with pregnancy and motherhood. These pre-existing cultural and creative practices provide an excellent context from which to explore, co-design and evaluate culturally-situated music-centred interventions that aim to reduce symptoms of anxiety and depression perinatally and facilitate mother-infant caregiving.PI Stewart and Co-Is Glover, Ramchandani and Cross, bring world-leading expertise across the domains of music and mental health, particularly perinatal mental health, while Co-I Cornelius brings world-leading expertise in the planning, development and analysis of clinical trials. International Co-I McConnell is a leading expert on the actual, as well as the potential roles of music in health contexts in The Gambia, where she has several years of experience in collaborative fieldwork. Within The Gambia we will work with collaborator Buba Darboe at the Ministry of Health and Social Welfare (MOH&SW), who brings understanding of existing health services and access to a network of primary healthcare workers throughout the country, and collaborator Hassoum Ceesay at the National Centre for Arts and Culture (NCAC), who brings understanding of the diversity of local musical practices and the meanings attached to them. We will employ two local graduate-level research assistants, one hosted at each site.

围产期心理健康问题影响全世界五分之一的妇女。怀孕期间的压力、焦虑和抑郁不仅会影响母亲，而且会通过子宫内的生物机制对孩子产生长期的不良影响。产后抑郁症会降低她提供敏感和反应灵敏的服务的能力，这也会损害儿童的发育。围产期心理健康问题是中低收入国家面临的一个特殊挑战，这些国家的发病率至少是高收入国家的两倍。我们开展这项工作的地理背景是西非冈比亚，那里的精神卫生服务最少，不存在围产期精神卫生服务，与精神卫生问题有关的高度耻辱感，以及特定的当地态度和信仰，阻碍了承认和防止寻求帮助的行为。因此，当务之急是开发新的低成本、低资源、非污名化和文化上适当的方法，以减少围产期焦虑和抑郁症状，造福母婴。目前的项目表明，创造性的艺术-特别是集体歌唱-可以显示在减轻冈比亚围产期精神痛苦的特殊承诺。在发达国家，如英国和美国，合唱已被证明是情绪和情感的强大调节剂，通过涉及同步，夹带和激素效应的机制，对心理健康，幸福感和社会关系产生积极影响。在冈比亚，以音乐为中心的方法可能特别有成效，因为已经存在一系列专门吸引孕妇和新妈妈的音乐实践。例如，婴儿命名仪式在出生后7天举行，是一种音乐庆祝活动，以表彰新母亲及其家人，Kanyeleng团体的表演与怀孕和母亲密切相关。这些已有的文化和创造性实践提供了一个很好的背景，从中探索，共同设计和评估文化定位的以音乐为中心的干预措施，旨在减少围产期焦虑和抑郁症状，促进母婴健康。PI Stewart和Co-Is格洛弗，Ramchandani和Cross，带来了音乐和心理健康领域的世界领先的专业知识，特别是围产期心理健康，而Co-I Cornelius在临床试验的规划、开发和分析方面拥有世界领先的专业知识。国际Co-I McConnell是冈比亚音乐在健康方面的实际和潜在作用的领先专家，她在合作实地工作方面有多年的经验。在冈比亚，我们将与卫生和社会福利部（MOH&SW）的合作者Buba Darboe合作，他将了解现有的卫生服务和全国各地的初级卫生保健工作者网络，以及国家艺术和文化中心（NCAC）的合作者Hassoum Ceesay，他将了解当地音乐实践的多样性及其意义。我们将聘请两名当地研究生水平的研究助理，一个在每个网站托管。

项目成果

How music may support perinatal mental health: an overview.

• DOI: 10.1007/s00737-021-01178-5
• 发表时间: 2021-10
• 期刊: Archives of women's mental health
• 作者: Sanfilippo KRM;Stewart L;Glover V
• 通讯作者: Glover V

A study protocol for testing the feasibility of a randomised stepped wedge cluster design to investigate a Community Health Intervention through Musical Engagement (CHIME) for perinatal mental health in The Gambia

一项研究方案，用于测试随机阶梯式楔形集群设计的可行性，以调查冈比亚围产期心理健康通过音乐参与（CHIME）进行社区健康干预

• DOI: 10.17863/cam.59681
• 发表时间: 2019
• 作者: Sanfilippo K

MOESM1 of A study protocol for testing the feasibility of a randomised stepped wedge cluster design to investigate a Community Health Intervention through Musical Engagement (CHIME) for perinatal mental health in The Gambia

MOESM1 的一项研究方案，用于测试随机阶梯式楔形集群设计的可行性，以调查冈比亚围产期心理健康通过音乐参与（CHIME）进行社区健康干预

• DOI: 10.6084/m9.figshare.10270940
• 发表时间: 2019
• 作者: Sanfilippo K

Community psychosocial music intervention (CHIME) to reduce antenatal common mental disorder symptoms in The Gambia: a feasibility trial.

• DOI: 10.1136/bmjopen-2020-040287
• 发表时间: 2020-11-23
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Sanfilippo KRM;McConnell B;Cornelius V;Darboe B;Huma HB;Gaye M;Ceesay H;Ramchandani P;Cross I;Glover V;Stewart L
• 通讯作者: Stewart L

The experience of maternal mental distress in The Gambia: A qualitative study identifying idioms of distress, perceptions of contributing factors and the supporting role of existing cultural practices.

• DOI: 10.1371/journal.pgph.0002329
• 发表时间: 2023
• 期刊: PLOS global public health