The "Wings" Depressive Symptom Intervention for Latina Mothers

项目摘要/摘要 LEP拉丁裔婴儿和幼儿的母亲面临着长期的经济困难和移民- 相关的压力源。高达%的人出现了临床上明显的抑郁症状，这些症状限制了他们 能够为他们的婴儿或蹒跚学步的孩子提供发展支持。婴幼儿接触母婴 抑郁症状与语言缺陷和持续的发育迟缓有关，在老年人中 儿童、行为障碍和社会攻击性。许多拉美裔在美国的“新目的地”地区 双语心理健康服务不足，拉美裔LEP母亲得不到治疗。《翅膀》 早期干预减少抑郁症状对80名拉丁裔LEP母亲有显著影响 先行先试(EHS)为了为更大规模的干预试验做准备，这项研究将最终完成对 干预并测试所选方法和方案的可行性、可接受性和安全性。这个 干预是对人际心理治疗(IPT)的10个疗程的家庭修改，由 会说英语的高级精神科护士与双语、项目培训的社区配对 口译员。它旨在帮助母亲减轻抑郁症状，应对压力，增加社交 更有效地支持和为人父母。对即将敲定的干预措施的改进包括战略 为了解决人际冲突和促进家庭主义[家庭团结]，额外的育儿指导 支持拉丁裔价值观的respeto[尊重]和教育[负责任的行动]，增加后- 干预维持会(PIM)，以延长症状的缓解并强调帮助 母亲与现有的社区机构建立联系，以获得同龄人和团体的社会支持。这项研究将 还测试针对病例管理/控制条件和登记前心理健康的方案 评估；确定招募、筛选和登记方案的可行性以及 管理以前的研究中没有使用的工具。最后，研究将评估可行性， 20名中心得分在16或以上的拉丁裔母亲对修订方法的可接受性和安全性 用于流行病学研究的抑郁量表(CES-D)和婴儿或幼儿在6周之间 36个月大，从社区机构招募。参与者将随机接受干预 或病例管理/控制条件，并在三个收集点(基线，12周)内测量 和6个月)。西班牙版的汉密尔顿抑郁症评级出售(HRSD)将与 与其他测量(PSI；CBCL；年龄和阶段问卷--社会-情绪；HSI-I，ARSMA-II， 社会支持和自我效能)。这项研究将支持更大规模的随机试验，并最终 将“翅膀”干预纳入社区诊所、早期干预计划和拉丁裔-- 服务机构。

Project Summary/Abstract LEP Latina mothers of infants and toddlers are confronted with chronic economic hardship and immigration- related stressors. As high as 64% experience clinically significant depressive symptoms, which limit their ability to offer developmental support to their infant or toddler. Infant/toddler exposure to maternal depressive symptoms has been linked to language deficits and persistent developmental lags, and in older children, conduct disorders and social aggression. Many "new destination" areas for Latinos in the US have inadequate bilingual mental health services and LEP Latina mothers cannot get treatment. The "Wings" intervention to reduce depressive symptoms had a significant impact in 80 Latina LEP mothers in Early Head Start (EHS). To prepare for a larger trial of the intervention, this study will finalize refinements to the intervention and test the feasibility, acceptability and safety of selected methods and protocols. The intervention is a 10-session, in-home modification of Interpersonal Psychotherapy (IPT) delivered by English-speaking advanced practice psychiatric nurses paired with bilingual, project-trained community interpreters. It is designed to help mothers reduce depressive symptoms, cope with stress, increase social support and parent more effectively. Refinements to the intervention that will be finalized include strategies to resolve interpersonal conflict and promote familismo [family unity], additional parenting guidance that supports Latino values of respeto [respectfulness] and educaci¿n [responsible actions], the addition of post- intervention maintenance sessions (PIMs) to prolong the reduction of symptoms and emphasis on helping mothers connect to existing community agencies to access peer and group social support. This study will also test protocols for a case management/control condition and a pre-enrollment mental health assessment; determine the feasibility of recruitment, screening and enrollment protocols and the administration of instruments not used in previous studies. Finally, the study will evaluate feasibility, acceptability and safety of the revised methods in 20 Latina mothers who score 16 or greater on the Center for Epidemiological Studies Depression Scale (CES-D) and who have infants or toddlers between 6 weeks and 36 months old recruited from community agencies. Participants will be randomized to the intervention or to a case management/control condition and measured over three collection points (baseline, 12 weeks and 6 months). Spanish versions of the Hamilton Rating Sale for Depression (HRSD) will be used along with other measures (PSI; CBCL; Ages and Stages Questionnaires - Social-Emotional; HSI-I, ARSMA-II, social support and self-efficacy). This study will support a larger randomized trial, and ultimately the integration of the "Wings" intervention into community clinics, early intervention programs and Latino- serving agencies.