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

产前到学前班：流行病对母亲和儿童的影响，重点是流行病对黑人家庭的影响

• 批准号: 10661084
• 负责人: Wanjiku Felicia Mbugua Njoroge
• 金额: $ 57.12万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-06 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661084
• 关键词: Achievement; Acute; Address; Adult; Adverse event; Age; Anxiety; Black race; COVID-19 pandemic; COVID-19 pandemic effects; Caregivers; Child; Child Behavior; Child Development; Child Health; Child Mental Health; Child Rearing; Clinical; Communities; Data; Development; Developmental Process; Diagnostic; Distress; Early identification; Education; Enrollment; Ensure; Environment; Environmental Risk Factor; Epidemic; Exposure disparity; Family; Fathers; Fostering; Fracture; Future; Goals; Health; Healthcare; Healthcare Systems; Height; Housing; Impairment; Indigenous; Inequity; Infant; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Latinx; Link; Longevity; Longitudinal cohort; Maternal Health; Mental Depression; Mental Health; Methods; Mother-Child Relations; Mothers; Neonatal; Nursery Schools; Outcome; Parent-Child Relations; Parents; Perception; Perinatal; Personal Satisfaction; Postpartum Period; Postpartum Women; Pregnant Women; Prospective Studies; Psychopathology; Questionnaires; Reporting; Research; Risk; Risk Factors; SARS-CoV-2 exposure; Sampling; Secondary to; Series; Severities; Social support; Stress; Structural Racism; Structure; Surveys; Symptoms; System; Time; Toddler; Trust; United States; Woman; adverse outcome; behavioral health; black women; care providers; emotion regulation; ethnic diversity; ethnic health disparity; experience; follow-up; health care disparity; health disparity; health equity; improved; negative affect; neurodevelopment; novel; pandemic disease; pandemic impact; physical conditioning; pregnant; prenatal; prevent; psychosocial; racial disparity; racial diversity; racism; recruit; resilience; resilience factor; screening; self reliance; social; stressor; symptomatology; syndemic; therapy development; time interval; transmission process

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.

摘要/摘要 COVID-19 全球大流行的出现对人们的健康和福祉产生了重大影响 成人和儿童都一样。在美国，COVID-19 大流行凸显了许多人的分裂 包括教育、经济、住房和医疗保健在内的系统，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重要性，这一点尤为重要。最近的 研究结果表明，早期母亲症状可能会对亲子产生持久的负面影响 互动、婴儿/儿童发展以及妇女和儿童的心理健康。总的来说，这些发现 在考虑黑人儿童及其家庭不同的接触环境时，这一点变得更加重要 结构性种族主义和 COIVD-19 大流行。尽管人们对结构性影响的认识不断增加 种族主义对儿童发育的影响从产前就开始了，支持这种传播的机制仍在研究中 调查了。确定女性受到 COVID-19 大流行和地方病的影响尤为严重 （综合症）在围产期期间，提供了了解发育中儿童的机会 环境、母亲的心理健康和育儿经历，长期目标是改善 通过确保适当、精确、文化上的婴儿/幼儿神经发育和心理健康结果 知情干预。拟议的多方法项目由三个目标组成，这三个目标将纵向 通过早期识别种族/民族不同的母亲来检查儿童的神经发育结果 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学，以及确定揭示交叉的弹性因素 可能存在的文化差异。父亲/二级照顾者也会完成类似的调查问卷 评估支持水平。第二个目标是母亲对孩子发育的关心和 两个发育时间点（24 个月和 48 个月）的心理健康状况，并评估母子之间的互动 一系列二元任务。最终目标包括对黑人女性子样本进行定性访谈 描述综合症对他们的心理健康、养育方式、对孩子的看法的影响 早期发展以及对医疗保健系统的信任。该应用程序的总体目标是深入 描述受流行病影响的妇女和儿童的经历，填补研究空白 通过确定对幼儿产生严重影响的具体母亲和环境因素及机制 发展和心理健康，并为未来的干预发展做好准备。