Developing and Testing of a Peer-Delivered Intervention for Depression

开发和测试同伴提供的抑郁症干预措施

• 批准号: 8043919
• 负责人: Mary C Acri
• 金额: $ 23.2万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8043919
• 关键词: Accounting; Address; Adopted; Adverse effects; Advocacy; Advocate; Attitude; Caregivers; Caring; Child; Clinical; Clinical Services; Cognitive; Color; Communities; Data; Development; Effectiveness; Emotional; Ensure; Family; Goals; Health; Health system; Healthcare; Intervention; Link; Low income; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Modeling; Mothers; National Institute of Mental Health; New York; Outcome; Parents; Participant; Policy Maker; Population Group; Positioning Attribute; Probability; Protocols documentation; Public Health; Research; Research Personnel; Research Project Grants; Resources; Risk; Role; Screening procedure; Services; Site; Stigmata; Testing; Training; Woman; Work; Youth; base; care seeking; community intervention; depressive symptoms; emotional distress; empowered; high risk; improved; innovation; maternal depression; motivational enhancement therapy; novel; peer; psychoeducation; role model; satisfaction; skills; skills training; social stigma; success; therapy development

DESCRIPTION (provided by applicant): The main aims of this proposed Exploratory Developmental Research Grant (R21: PA-10-069) are to: (1) develop a peer-delivered intervention by adapting well-established clinical strategies, (2) evaluate the feasibility and acceptability of the intervention in non-clinical, community-based settings from the perspective of key stakeholders (e.g. mothers, Family Peer Advocates (FPA), and supervisors), taking into account implementation supports for FPA to deliver the intervention in non-clinical settings; and (3) develop and test preliminary indicators of fidelity to the intervention. Low-income women of color and mothers who seek FPA- delivered services are at high risk for depression, yet their mental health needs are often undetected and unaddressed. They are unlikely to seek treatment on their own due to stigma and misperceptions about mental health and treatment. Active intervention strategies to assist mothers in identifying depressive symptoms and engage in clinical services are critical given the risks of maternal depression upon the child, mother, and family. FPAs, who are also caregivers of youth with psychiatric needs, are in a unique position to fulfill this role because they are viewed as trustworthy, credible role models who provide hope, empower participants and enhance satisfaction with services. However, many FPAs feel that they lack the skills and training to appropriately address caregivers' mental health needs. Thus, the goal of this project is to develop and evaluate an intervention to improve the identification of depression and linkage to mental health services for predominantly low-income, mothers of color caring for youth with psychiatric needs. To fulfill the study aims, the investigative team will be guided by the Deployment-Focused Model (DFM) of treatment development and testing, and adopt a participatory collaborative model to develop an intervention in partnership with a Family Advocacy and Research Board composed of policy-makers, consumers, researchers and FPA from the proposed study sties. We will train 10 FPA to deliver the intervention to 20 caregivers evidencing depressive symptoms, and gather data from mothers, FPA, and supervisors in order to investigate the feasibility and acceptability of the intervention. We will also develop and preliminarily test fidelity measures in anticipation of a larger effectiveness study. The proposed study is innovative in the following three ways: (1) it directly focuses on the mental health needs of mothers, recognizing the treatment of caregiver mental health as critical in its own right, (2) the clinical strategies are derived from well-established strategies typically delivered by clinicians, but have not yet been utilized by FPA in non-clinical settings, and, (3) this study adopts a community engagement approach, use of a Deployment-Focused Model, and strong linkages to NYS Office of Mental Health and a Family Advocacy and Research Board to ensure that if feasible, this model will likely be rapidly disseminated across the state. Data from this project will refine the intervention and protocol, and guided by the DFM, will inform a larger R34 or R01 study examining caregiver and child outcomes if warranted. PUBLIC HEALTH RELEVANCE: The proposed study is relevant to public health considering the numerous adverse effects associated with untreated maternal depression on the child, parent, and family by developing and evaluating an innovative screening and linkage model to improve the identification of depression and linkage to mental health services.

DESCRIPTION (provided by applicant): The main aims of this proposed Exploratory Developmental Research Grant (R21: PA-10-069) are to: (1) develop a peer-delivered intervention by adapting well-established clinical strategies, (2) evaluate the feasibility and acceptability of the intervention in non-clinical, community-based settings from the perspective of key stakeholders (e.g. mothers, Family Peer Advocates （FPA）和主管），考虑到FPA在非临床环境中提供干预的实施支持； （3）开发和测试对干预的忠诚度的初步指标。有色人种的低收入妇女和寻求FPA交付服务的母亲面临抑郁症的高风险，但她们的心理健康需求常常未被发现且未经应对。由于污名和对心理健康和治疗的误解，他们不太可能自行寻求治疗。鉴于儿童，母亲和家庭有孕产妇抑郁症的风险，积极的干预策略以帮助母亲识别抑郁症状并参与临床服务至关重要。 FPA也是有精神病需求的青年照顾者，他处于履行这一角色的独特地位，因为他们被视为可信赖，可信的榜样，他们提供希望，赋予参与者权力并增强对服务的满意度。但是，许多FPA认为他们缺乏适当满足看护人心理健康需求的技能和培训。因此，该项目的目的是开发和评估一种干预措施，以改善抑郁症和与精神卫生服务联系的识别，主要是低收入，有色的母亲照顾有精神病患者的青年。为了实现研究的目的，调查团队将由以部署为中心的治疗开发和测试模型（DFM）指导，并采用参与式合作模型，与由政策制定者，消费者，研究人员，研究人员和FPA组成的家庭倡导和研究委员会合作开发干预措施，这些委员会的研究阶段。我们将培训10个FPA，以将干预措施提供给20名看出抑郁症状的护理人员，并从母亲，FPA和主管那里收集数据，以调查干预措施的可行性和可接受性。我们还将制定和初步测试预期效率研究的忠诚度措施。拟议的研究通过以下三种方式具有创新性：（1）它直接关注母亲的心理健康需求，认识到护理人员的心理健康本身至关重要，（2）临床策略是临床策略从临床医生提供的良好策略中得出的，通常是由临床医生提供的良好策略，但尚未由FPA在非临床设施中使用，但在非临床方面使用了A Demotive a This Indording A Frestion，A-F Andive a Frestion a Frestion a Frestion a Frestion a Fress A a Frestion（3）（3）（3）（3）（3）（3）（3）模型，以及与纽约州心理健康办公室以及家庭倡导和研究委员会的紧密联系，以确保如果可行，该模型可能会在全州迅速传播。该项目的数据将完善干预和协议，并在DFM的指导下，将告知较大的R34或R01研究，以检查护理人员和儿童结果（如果有必要）。 公共卫生相关性：拟议的研究与公共卫生有关，考虑到与未经治疗的孕产妇抑郁症对儿童，父母和家庭的不利影响，通过开发和评估创新的筛查和连锁模型，以改善抑郁症和与心理健康服务的联系。