Improving Preschool Outcomes by Addressing Maternal Depression in Head Start

通过提前解决母亲抑郁症问题来改善学前教育成果

• 批准号: 9884948
• 负责人: EMILY FEINBERG
• 金额: $ 77万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-13 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9884948
• 关键词: Absenteeism; Academic achievement; Academy; Adaptive Behaviors; Address; Adherence; Affect; Affective; Area; Award; Behavior; Behavioral; Caring; Child; Child Rearing; Cognitive; Communities; Conflict (Psychology); Depressed mood; Development; Education; Effectiveness; Employee; Environmental Risk Factor; Face; Family; Feasibility Studies; Funding; Goals; Head Start Program; Healthcare; Intervention; Link; Low income; Massachusetts; Measures; Medicine; Mental Depression; Mental Health; Mental Health Services; Minority; Modeling; Mother-Child Relations; Mothers; National Institute of Child Health and Human Development; Nursery Schools; Outcome; Parents; Pattern; Perception; Personal Satisfaction; Pilot Projects; Population; Prevention; Prevention program; Prevention strategy; Problem Solving; Process; Protocols documentation; Provider; Public Health; Publishing; Randomized; Readiness; Reporting; Research; Research Priority; Risk; Sampling; Schools; Series; Services; Site; Social Work; Stress; Symptoms; Testing; United States National Institutes of Health; Woman; arm; base; coping; depressive symptoms; design; effectiveness trial; efficacy testing; efficacy trial; experience; health disparity; improved; improved outcome; intervention effect; lower income families; maternal depression; multi-component intervention; pilot trial; population based; prevent; programs; randomized trial; reduce symptoms; resilience; skills; social; social factors; social skills; stress management; symptomatology

PROJECT SUMMARY Children of low-income families face myriad social risks that interfere with healthy development, behavior, and academic achievement. Mothers of these children experience a high rate of depression, itself associated with lasting effects on children. In 2009, the National Academy of Medicine published a landmark report, Depression in Parents, Parenting, and Children, in which it called for community-based interventions to prevent parental depression and to help engage depressed parents in treatment. Consistent with this report, our research group has conducted a series of NIH-funded studies aimed at alleviating symptoms among mothers at risk for depression in Head Start – a federally funded preschool program that provides services for ~1 million low-income US families. In the present project, we aim to improve outcomes for Head Start children by deploying a stepped-care intervention, in which mothers with low level depressive symptoms are offered a prevention program based on the Problem Solving Education model, and mothers with greater symptoms are offered Engagement Sessions to link them with formal mental health services. Both components of the model have strong randomized trial evidence; but they have yet to be synthesized and tested within a coordinated intervention, applicable to a broad population base. Harnessing a research network of Head Start centers in Massachusetts, we propose an efficacy trial (n=388) of this stepped-care model. Our primary aim is to determine the model’s efficacy in decreasing the rate at which Head Start mothers experience depressive symptom episodes; mothers’ likelihood of engaging with mental health services when referred; parental functioning; and child absenteeism from Head Start. Our second aim is to determine mechanisms of action by which improved maternal wellbeing promotes child resiliency. To do this, we will assess mothers’ perceptions of stress, family conflict, and mother-child interaction patterns; and we will assess child outcomes in the affective, interpersonal and cognitive domains. Finally, to prepare for a subsequent effectiveness trial, we will conduct a single arm pilot study among 20 additional mothers to assess the feasibility of incorporating intervention delivery into usual Head Start workflow. Our proposal represents a high-priority research area for NICHD because it addresses social and environmental factors that impact children’s adaptive behaviors and school readiness. Our study plan enhances the rigor of prior research because it tests the efficacy of a comprehensive depression management model, and because our design allows us to study both maternal and child outcomes – and the mechanisms that link them – among a true community-based sample. Our ultimate goal is to reduce mental health disparities for low-income mothers and to improve outcomes for them and their children.

项目总结