Effects of a Prenatal Depression Preventive Intervention on Parenting and Young Children's Self-Regulation and Functioning (EPIC)

产前抑郁症预防干预对育儿和幼儿自我调节和功能的影响 (EPIC)

• 批准号: 10629270
• 负责人: Shiv Darius Tandon
• 金额: $ 64.21万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-07 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10629270
• 关键词: Address; Adolescent; Adopted; Adverse effects; Affect; Age; Age Months; Awareness; Behavioral; Child; Child Development; Child Health; Child Rearing; Clinical; Cognitive; Cognitive Therapy; Community based prevention; Data; Data Collection; Depressed mood; Development; Eligibility Determination; Enrollment; Ethnic Origin; Etiology; Exhibits; Family; Fathers; Feeling; Fostering; Funding; Future; Home; Home visitation; Informal Social Control; Intervention; Knowledge; Link; Low income; Major Depressive Disorder; Maternal Behavior; Maternal Health; Maternal and Child Health; Measurement; Medial; Mediating; Mental Health; Methods; Modeling; Mothers; Nursery Schools; Observational Study; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Patient-Focused Outcomes; Performance; Personal Satisfaction; Play; Postpartum Period; Preventive; Public Health; Randomized, Controlled Trials; Research Institute; Research Personnel; Role; Sample Size; Sampling; Science; Services; Site; Societies; Surveys; Testing; Thinking; Time; United States; Woman; Work; antepartum depression; base; causal model; critical period; depressive symptoms; early childhood; ethnic diversity; evidence base; follow-up; group intervention; improved; informant; innovation; intervention effect; intervention participants; low socioeconomic status; maternal depression; maternal outcome; mood regulation; motherhood; neurodevelopment; offspring; parental influence; performance based measurement; peripartum depression; prenatal; prevent; preventive intervention; programs; racial diversity; racial minority; recruit; skill acquisition; skills; sociodemographic factors; sociodemographic variables; theories; trial enrollment

PROJECT SUMMARY The proposed R01 project (EPIC) examines whether a prenatal depression prevention intervention—Mothers and Babies (MB)—improves parenting practices and child self-regulation through 54 months of age. We build on an existing cluster randomized controlled trial that enrolled 874 diverse, low-income women from 36 home visiting (HV) programs. We anticipate 598 of these women will be eligible for EPIC (489 intervention, 109 control) and we will enroll an additional 260 control participants as part of this R01, for a total sample of 858. We will also enroll 429 fathers. Perinatal depression is consistently linked to poor parenting practices and poor child self-regulation. This project builds on previous work that has demonstrated MB’s effects on improving maternal mental health outcomes and will examine the intervention’s longer-term impact on parenting and child self-regulation from 30-54 months of age. Intervention participants will have received the six-week MB intervention delivered in a group format in addition to usual HV services while control participants will have only received HV services. Data collection for the R01 includes maternal self-report with all 858 participants every six months, beginning at 30 months postpartum and continuing until 54 months postpartum. An intensive sub- study of parenting and child development will occur at 36, 42, and 48 months for a subset of 460 participants (230 intervention, 230 control). Paternal self-report surveys will occur at 30, 42, and 54 months. There are three specific aims. First, we test the hypothesis that MB improves parenting and child self-regulatory skill acquisition through 54 months of age. We will use intent-to-treat as well as propensity score adjusted analysis. Second, we test hypotheses about the maternal mechanisms by which MB influences parenting and child self- regulation. We hypothesize that MB intervention effects will be mediated by core skills targeted by MB—in particular, increased awareness of thoughts and feelings and increases in mood regulation—as these cognitive-behavioral skills are deficient in mothers with depressive symptoms and compromise mothers’ ability to engage in parenting practices that promote young children’s self-regulation. Third, we will examine fathers’ and other key sociodemographic variables’ role in moderating the impact of MB on mother’s parenting and the child’s self-regulation. The public health significance and innovation of this project is substantial. Addressing maternal mental health has been identified as a highly impactful enhancement to HV programs. If, as expected, we are able to generate a robust science base that precisely identifies mechanisms and outcomes impacted by the intervention in young children among our racially and ethnically diverse sample, HV programs currently using MB are likely to enhance their programmatic outcomes. Moreover, given the large number of HV programs that could adopt MB nationally, findings from this study can provide powerful data suggesting that MB become integrated into their core set of services.

项目总结 拟议的R01项目(EPIC)调查了一项产前抑郁症预防干预措施--母亲 和婴儿(MB)-在54个月大的过程中改善育儿实践和儿童自我调节。我们建造 在现有的一项随机分组对照试验中，从36个家庭招募了874名不同的低收入女性 参观(HV)项目。我们预计其中598名妇女将有资格接受EPIC(489名干预，109名 作为R01的一部分，我们将额外招募260名对照参与者，总样本为858人。 我们还将招收429名父亲。围产期抑郁始终与不良的父母养育方式和糟糕的 儿童自律。这个项目建立在以前工作的基础上，这些工作已经证明了甲基溴在改善 并将检查干预措施对育儿和子女的长期影响 30-54个月龄的自我调节。干预参与者将收到为期六周的MB 除了通常的高压服务外，以小组形式提供的干预措施，而对照组参与者将仅有 接受高压服务。R01的数据收集包括母亲自我报告，所有858名参与者每年 六个月，从产后30个月开始，一直持续到产后54个月。一次密集的潜水 关于育儿和儿童发展的研究将在36个月、42个月和48个月时进行，参与者为460人 (干预230例，对照230例)。父亲的自我报告调查将在30、42和54个月时进行。确实有 三个具体目标。首先，我们检验了MB改善父母教养方式和儿童自我调节能力的假设 通过54个月的年龄获得。我们将使用意向治疗以及倾向分数调整分析。 第二，我们检验了关于母性机制的假设，即母性机制通过MB影响父母教养方式和孩子的自我 监管。我们假设MB干预效果将由MB-In针对的核心技能进行调节 特别是，提高了对思想和感觉的意识，增加了情绪调节--就像这些 有抑郁症状并损害母亲能力的母亲认知行为技能不足 参与促进幼儿自我调节的育儿实践。第三，我们将审查父亲的 以及其他关键的社会人口统计变量在缓和甲基溴对母亲养育和 儿童的自我调节。这一项目的公共卫生意义和创新是实质性的。寻址 产妇的心理健康已被确定为对HV计划的高度影响的增强。如果，如 预计，我们能够产生一个强大的科学基础，准确地识别机制和结果 受到我们种族和民族多元化样本中对幼儿的干预的影响，HV计划 目前使用甲基溴的国家有可能提高其方案成果。此外，考虑到大量的 可以在全国范围内采用甲基溴的高压项目，这项研究的发现可以提供强有力的数据表明 将MB整合到他们的核心服务集合中。