Prenatal to Preschool: The Impact of the Pandemic on Mothers and children, with a focus on syndemic effects on Black families

摘要/摘要 新冠肺炎全球大流行的出现对人们的健康和福祉产生了重大影响 大人和孩子都一样。在美国，新冠肺炎疫情凸显了许多疾病的裂痕 包括教育、经济、住房和医疗保健在内的制度，扩大了已知的种族差距。这是 考虑到围产期对早期神经发育的危害性，这一点尤为重要。近期 研究结果表明，早期的产妇症状可以对亲子产生持久的负面影响。 妇女和儿童的互动、婴儿/儿童发展和心理健康。总体而言，这些发现 在将黑人儿童及其家庭暴露在不同环境中的背景联系起来时，显得更加重要 结构性种族主义和COIVD-19大流行。尽管人们对结构性金融危机的影响有越来越多的了解 关于儿童发展的种族主义从产前就开始了，这种传播的基础机制仍然 调查过了。确定受新冠肺炎大流行和地方病影响不成比例的妇女 (合并症)在围产期，提供了一个机会来了解发育中的孩子的 环境、母亲的心理健康和育儿经验，长期目标是改善 婴幼儿神经发育和心理健康的结果，通过确保适当、准确、文化上- 知情干预。拟议的多方法项目由三个目标组成，这些目标将纵向 通过早期识别种族/民族多样化的母亲来检查儿童神经发育结果 心理健康挑战。第一个目标是对产后黑人和非拉丁裔进行广泛筛查 白人(NLW)母亲使用一系列问卷和临床精神病学访谈来识别母亲 目前正在经历痛苦和精神病理，以及确定弹性因素揭示交叉- 可能存在的文化差异。父亲/二级照顾者也将完成类似的问卷调查 评估支持程度。第二个目标是确定母亲对孩子发育的关注，以及 在两个发育时间点(24个月和48个月)的心理健康，并评估母子互动 一系列的二元任务。最终目标是对黑人女性的一个小样本进行定性访谈 表征合并症对他们的心理健康的影响，父母的做法，对他们孩子的看法 早期开发，以及对医疗保健系统的信任。此应用程序的总体目标是深入 描述受合并症影响的妇女和儿童的经历，填补研究空白 通过确定对早期儿童产生严重影响的特定母体和环境因素和机制 发展和心理健康，并允许未来的干预发展。

SUMMARY/ABSTRACT The emergence of the COVID-19 global pandemic has had significant impact on the health and well-being of adults and children alike. In the United States, the COVID-19 pandemic has highlighted the fractures in many systems including education, the economy, housing, and healthcare, widening known racial disparities. This is of particular importance considering the criticality of the peripartum period on early neurodevelopment. Recent findings suggest that early maternal symptomatology can have lasting, and negative effects on parent-child interactions, infant/child development, and mental health of both women and children. Overall, these findings take on further importance when contextualizing the disparate exposure of Black children and their families to structural racism and the COIVD-19 pandemic. Although there is increasing knowledge of the impact of structural racism on child development beginning prenatally, mechanisms underpinning this transmission are still being investigated. Identifying women disproportionately impacted by the COVID-19 pandemic and endemic conditions (syndemic) during the peripartum period, provides an opportunity to understand the developing child’s environment, mother’s mental health, and parenting experience, with the long-term goal of improving infant/young child neurodevelopmental and mental health outcomes by ensuring appropriate, precise, culturally- informed interventions. The proposed multi-methods project consists of three aims that will longitudinally examine child neurodevelopmental outcomes by early identification of racially/ethnically diverse mothers with mental health challenges. The first aim implements extensive screening of postpartum Black and non-Latinx White (NLW) mothers using a battery of questionnaires and clinical psychiatric interviews to identify mothers currently experiencing distress and psychopathology, as well as determining resilience factors uncovering cross- cultural differences that may exist. Fathers/secondary caregivers will also complete similar questionnaires assessing levels of support. The second aim identifies maternal concern about their child’s development and mental health at two developmental time points (24 and 48-months) and assesses mother/child interactions on a series of dyadic tasks. The final aim consists of qualitative interviews with a sub-sample of Black women characterizing the impact of the syndemic on their mental health, parenting practices, perceptions of their child’s early development, and trust in the healthcare system. The overarching goal of this application is to deeply characterize the experiences of women and children impacted by the syndemic, filling the gap in the research by identifying specific maternal and environmental factors and mechanisms that critically influence early child development and mental health and allowing for future intervention development.