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.

围产期情绪和焦虑症(PMADs)对身体有代际的负面影响 妇女及其家庭的健康和心理健康，并且是最常经历分娩的 很复杂。PMADs在农村人口中特别常见，他们在 获得妇幼保健和精神卫生服务。杜拉，未经医学训练 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，并作为改善精神健康结果的一种方式，以及其他妇幼保健结果，如 减少药物使用，增加产前和产后保健就诊次数，以及 改善产妇的整体身体健康状况。本研究的目的是：1)探索使用 改善农村人口的自我效能感和孕产妇心理健康结果；2)制定 改善农村人群自我效能感和孕产妇心理健康的导乐干预；以及3)试点 达拉领导的干预措施，以提高自我效能和母亲的心理健康结果。用NIM...‘S 实验治疗学方法，我将探索影响这些结果的潜在机制 通过关注杜拉如何提高客户的自我效能感。遵循惠特贝克(2006)的模型 为了适应干预措施和基于社区的参与性研究(CBPR)的最佳做法，我将 使用形成性和探索性研究方法来解决有关使用Doulas的知识差距 改善PMADs和次级母婴健康结果。通过这个项目，我们将首先 收集有关使用DULA改善PMAD健康结果的可行性的初步定性数据 并将确定获得精神卫生保健的需求和障碍，以及社会和情感方面的需求和障碍 可以由杜拉斯解决的支持(N=40)。然后，拟议的研究将综合 关于使用杜拉斯和同行支助模式的定量数据，其中定性数据收集自 半结构化访谈，通过调整现有的 助产士--训练。将采用混合方法分析研究参与者(N=75)的研究结果。 杜拉和供应商(N=20)。该项目将为文化适应提供初步数据。 供其他边缘化群体和农村人口使用的干预措施，包括土著 社区，他们经历了PMADs增加和其他负面的妇幼保健结果。