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）对身体健康有代际负面影响。 妇女及其家庭的健康和心理健康，是最经常经历的分娩 并发症PMAD在农村人群中特别常见，他们在以下方面经历了额外的障碍： 获得妇幼保健和精神保健服务。助产士，未经医学培训 分娩和产后陪伴，已被提议作为解决现有医疗保健的一种方式， 差距，并作为改善心理健康结果的一种方式，沿着其他妇幼保健结果， 减少物质使用，增加产前和产后保健就诊率， 改善产妇的整体身体健康。本研究的目的是：1）探索 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）制定一项 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a 由doula领导的干预措施，以提高自我效能和孕产妇心理健康成果。使用NIM…的 实验治疗方法，我将探讨影响这些结果的潜在机制 通过关注导卫如何提高客户的自我效能。遵循Whitbeck（2006）的模型 为了适应干预措施和基于社区的参与式研究（CBPR）的最佳实践，我将 使用形成性和探索性研究方法，以解决有关使用导乐的知识差距 改善PMAD和次级孕产妇和婴儿健康结果。通过这个项目，我们将首先 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的需求和障碍，以及社会和情感 可以通过导乐解决的支持（N=40）。该研究将综合 关于使用导乐会和同伴支持模式的定量数据，以及从以下方面收集的定性数据： 半结构化访谈，通过调整现有的 导乐训练将使用混合方法分析研究参与者（N=75）的结果 导乐和提供者（N=20）。该项目将为文化适应提供初步数据， 其他边缘化群体和农村人口，包括土著居民， 社区，谁经历加剧PMAD和其他负面的妇幼保健结果。