Addressing perinatal mood and anxiety disorders (PMADs) through a doula intervention

通过导乐干预解决围产期情绪和焦虑障碍 (PMAD)

• 批准号: 10861961
• 负责人: Jessica Liddell
• 金额: $ 17.19万
• 依托单位: UNIVERSITY OF MONTANA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10861961
• 关键词: Address; Anxiety Disorders; Area; Centers for Population Health; Childbirth; Client; Companions; Complication; Data; Emotional; Family; Health; Health Care Visit; Healthcare; Infant Health; Intervention; Interview; Investigational Therapies; Knowledge; Maternal Health; Maternal and Child Health; Mental Health; Mental Health Services; Methods; Modeling; Montana; Mood Disorders; Outcome; Participant; Perinatal; Personal Satisfaction; Postpartum Period; Pregnancy; Provider; Research; Rural Population; Self Efficacy; Structure; Testing; Training; Women' s Health; community based participatory research; experience; improved; indigenous community; intergenerational; marginalized population; peer support; physical conditioning; postpartum health; prenatal; social; substance use; suicide rate

Perinatal mood and anxiety disorders (PMADs) have intergenerational negative impacts on the physical and mental health of women and their families and are the most frequently experienced childbirth complication. PMADs are particularly common in rural populations, who experience additional obstacles in accessing maternal and child health (MCH) and mental health services. Doulas, non-medically trained childbirth and postpartum companions, have been proposed as one way to address existing healthcare gaps, and as a way to improve mental health outcomes, along with additional MCH outcomes such as decreased substance use, increased prenatal and postpartum healthcare visit attendance, and improvements in overall maternal physical wellbeing. The aims of this research are: 1) Explore the use of doulas to improve self-efficacy and maternal mental health outcomes for rural populations; 2) Develop a doula intervention to improve self-efficacy and maternal mental health in rural populations; and 3) Pilot a doula-led intervention to improve self-efficacy and maternal mental health outcomes. Using the NIM....'s experimental therapeutics approach, I will explore the underlying mechanism impacting these outcomes by focusing on how doulas improve self-efficacy among their clients. Following Whitbeck's (2006) model for adaptation of interventions, and community-based participatory research (CBPR) best practices, I will use formative and exploratory research approaches to address knowledge gaps about the use of doulas to improve PMADs and secondary maternal and infant health outcomes. Through this project we will first collect primary qualitative data regarding the feasibility of using doulas to improve PMAD health outcomes and will identify the needs and barriers in accessing mental health care, as well as social and emotional support that could be addressed by doulas (N=40). The proposed research will then synthesize quantitative data on the use of doulas and peer-support models with qualitative data collected from semi-structured interviews to develop and test a doula-led intervention through adapting an existing doula-training. A mixed-methods approach will be used to analyze findings from study participants (N=75) and doulas and providers (N=20). This project will provide preliminary data for the cultural adaptation of the intervention for use with other marginalized groups and rural populations, including Indigenous communities, who experience heightened PMADs and other negative MCH outcomes.

围产期情绪和焦虑障碍 (PMAD) 对身体产生代际负面影响 和妇女及其家人的心理健康，是最常经历的分娩 并发症。 PMAD 在农村人口中尤其常见，他们在生活中遇到更多障碍 获得妇幼保健 (MCH) 和心理健康服务。导乐师，未接受过医学培训 分娩和产后陪伴已被提议作为解决现有医疗保健问题的一种方法 差距，并作为改善心理健康结果的一种方式，以及其他妇幼保健结果，例如 减少物质使用，增加产前和产后保健就诊人数，以及 改善孕产妇的整体身体健康。本研究的目的是： 1) 探索使用 导乐以提高农村人口的自我效能和孕产妇心理健康结果； 2）开发一个 导乐干预，以提高农村人口的自我效能和孕产妇心理健康； 3) 试点 导乐主导的干预措施，以提高自我效能和孕产妇心理健康结果。使用 NIM.... 的 实验治疗方法，我将探索影响这些结果的潜在机制 通过关注导乐如何提高客户的自我效能。遵循 Whitbeck (2006) 模型 为了适应干预措施和基于社区的参与性研究 (CBPR) 最佳实践，我将 使用形成性和探索性研究方法来解决有关导乐使用的知识差距 改善 PMAD 和次要孕产妇和婴儿健康结果。通过这个项目我们首先 收集有关使用导乐改善 PMAD 健康结果的可行性的主要定性数据 并将确定获得精神卫生保健以及社会和情感方面的需求和障碍 可由导乐师提供的支持 (N=40)。然后，拟议的研究将综合 关于导乐和同伴支持模式使用情况的定量数据以及从以下机构收集的定性数据 半结构化访谈，通过调整现有的方法来开发和测试导乐主导的干预措施 导乐培训。将使用混合方法来分析研究参与者的发现（N = 75） 导乐师和提供者 (N=20)。该项目将为文化适应提供初步数据 与其他边缘化群体和农村人口（包括土著居民）一起使用的干预措施 经历 PMAD 加剧和其他负面 MCH 结果的社区。