Adapting a novel mental health prevention intervention for migrant mothers with young children in a humanitarian setting

在人道主义环境中为有幼儿的移民母亲采用新颖的心理健康预防干预措施

• 批准号: 10730411
• 负责人: IETZA BOJORQUEZ
• 金额: $ 61.57万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-16 至 2026-08-15
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730411
• 关键词: Address; Anxiety; Border Community; Border Crossings; Child; Child Care; Child Mental Health; Child Rearing; Conflict (Psychology); Control Groups; Cultural Sensitivity; Development; Economics; Equity; Evidence based intervention; Face; Focus Groups; Food; Future; Gender; Goals; Health; Health Services Accessibility; Housing; Immigration; Individual; Intervention; Intervention Studies; Link; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mental health promotion; Mexico; Migrant; Migration Policy; Mothers; National Institute of Mental Health; Outcome; Pilot Projects; Policies; Politics; Population; Post-Traumatic Stress Disorders; Prevention; Protocols documentation; Randomized, Controlled Trials; Reporting; Resources; Shelter facility; Social isolation; Social support; Strategic Planning; Stress; Surveys; Testing; Time; Translating; Trauma; Travel; Uncertainty; Underserved Population; Violence; Woman; Work; Writing; climate change; demographics; depressive symptoms; disparity reduction; efficacy trial; evidence base; experience; follow-up; group intervention; high risk; improved; intervention refinement; migration; multi-component intervention; novel; pilot test; post intervention; preventive intervention; programs; promote resilience; protective effect; reduce symptoms; resilience; response; selective prevention; social structure; standard of care; stressor; structural determinants; theories; trauma exposure; trauma symptom

PROJECT SUMMARY/ABSTRACT The goal of this pilot study is to adapt and pilot-test a novel mental health prevention intervention for migrant mothers with young children (MMC) in a humanitarian setting. Global migration is rising at record-high rates, with the number of women traveling with children continuing to rise at the U.S.-Mexico border. Tijuana, Mexico is located at the busiest land border crossing globally and faces an unprecedented humanitarian crisis resulting from displacement due to violence, political conflict, lack of economic opportunity, and climate change, exacerbated by migration policies that have forced hundreds of thousands of migrants to wait in Mexico under prolonged and unsafe conditions. Migrant women in transit in such contexts face high risk of developing mental disorders such as depression and anxiety, driven by gendered social-structural factors including violence, social isolation, migration uncertainty, and limited access to services. Although migrants in transit who endure such conditions have high need for mental health prevention, few evidence-based interventions are tailored to migrant women in transit. Moreover, while women and children’s mental health in humanitarian contexts are interconnected, few mental health interventions address parenting needs. We propose to adapt ‘Mamá Empoderada’ [Mom Power] - a theory-based, trauma-informed group intervention to promote mental health and positive parenting among mothers with young children (0-5 years) for the first time with MMC. This multi- component intervention includes a parenting program alongside activities to address social-structural vulnerabilities (e.g., connection to resources, strengthening social support). It has demonstrated efficacy on reduced parenting stress and mental health symptoms for trauma-exposed U.S. mothers and has recently been translated into Spanish. Our specific aims are to 1) Adapt, pre-test, and refine ‘Mamá Empoderada’ with MMC in a humanitarian context; 2) Conduct a pilot study of the adapted intervention to determine acceptability and estimate effect sizes on symptoms of depression, anxiety, and parenting stress; and 3) Explore which theory-based mechanisms of action predict changes in symptoms of depression, anxiety, and parenting stress, and identify factors associated with differential intervention response. We will conduct focus groups and pre- testing to adapt and refine the intervention, and conduct a pilot RCT of the adapted intervention with MMC (N=100; Ntreatment=50; Ncontrol=50). The intervention group (IG) will receive trauma-informed group and individual sessions on parenting, linkage to resources (e.g., food, shelter), social support, and resilience. The control group will receive written intervention materials, standard of care programming, and participate in the intervention following completion of the study by the IG (i.e., after 6 months). Both groups will complete baseline and exit surveys, as well as follow-up surveys at 3- and 6- months post-intervention. Amid rising population displacement and prolonged and traumatic migration journeys, this study addresses an urgent need for scalable and tailored mental health prevention for MMC in transit in humanitarian contexts.

项目摘要/摘要 本研究的目的是对一种新的流动人口心理健康预防干预措施进行调整和试点测试 在人道主义背景下帮助有幼儿的母亲。全球移民正以创纪录的速度增长， 随着美国带孩子旅行的女性人数持续上升，墨西哥边境。墨西哥蒂华纳 位于全球最繁忙的陆地边境口岸，面临着前所未有的人道主义危机， 由于暴力、政治冲突、缺乏经济机会和气候变化而流离失所， 由于移民政策迫使数十万移民在墨西哥等待， 长期和不安全的条件。在这种情况下过境的移徙妇女面临着患精神疾病的高风险。 由包括暴力在内的性别社会结构因素驱动的抑郁和焦虑等疾病， 社会隔离、移徙不确定性和获得服务的机会有限。虽然过境的移民忍受着 这种情况对心理健康预防的需求很高，很少有基于证据的干预措施是专门针对 过境移徙妇女。此外，虽然人道主义背景下的妇女和儿童心理健康问题 由于这些问题相互关联，很少有心理健康干预措施能够解决养育子女的需要。我们建议改编“妈妈” Empoderada' [妈妈的力量] -一个基于理论的，创伤知情的群体干预，以促进心理健康 第一次使用MMC，在有幼儿（0-5岁）的母亲中进行积极的养育。这多- 组成部分的干预包括一个育儿计划，以及解决社会结构问题的活动。 脆弱性（例如，加强社会支持（社会支持）。它已被证明有效， 减少了遭受创伤的美国母亲的育儿压力和心理健康症状， 被翻译成西班牙语。我们的具体目标是1）适应，预测试，并完善'妈妈Empoderada'与 在人道主义背景下的MMC; 2）对调整后的干预措施进行试点研究，以确定可接受性 并估计对抑郁症、焦虑症和育儿压力症状的影响大小; 3）探索 以理论为基础的作用机制可以预测抑郁、焦虑和养育压力症状的变化， 并确定与不同干预反应相关的因素。我们将举行焦点小组讨论会， 测试以调整和完善干预措施，并对MMC进行适应性干预措施的试点RCT （N=100; N处理=50; N对照=50）。干预组（IG）将接受创伤知情组和个人 关于养育子女、与资源的联系（例如，食物、住所）、社会支持和复原力。控制 小组将收到书面干预材料，标准护理方案，并参加 在IG完成研究后进行干预（即，6个月后）。两组将完成 基线和离职调查，以及干预后3个月和6个月的后续调查。因此不断加剧 人口流离失所和长期和创伤性的迁移旅程，这项研究解决了迫切需要 为在人道主义背景下过境的MMC提供可扩展和量身定制的心理健康预防。