MomNet: Development of a Coach-Training Program for an Empirically Supported, Guided ehealth Intervention for Depressed Mothers

项目摘要/摘要 年幼子女的低收入母亲代表着一个弱势群体，她们面临着患上 这些人患有抑郁症，获得心理健康服务的机会越来越有限。尽管 在获得有效治疗的情况下，大多数抑郁症患者得不到治疗。在众多的 治疗的障碍，其中最实质性的几个包括缺乏心理健康保险，安排困难 儿童保育和交通工具的缺乏对社会经济地位较低的妇女产生了不同的影响。对于农村地区 对于妇女来说，这些困难可能会因为在合理距离内缺乏提供者而变得更加困难。在我们的 在之前的工作中，为了解决访问障碍，我们开发并评估了一个由互联网支持的母亲网 针对有年幼子女的母亲量身定做的针对抑郁症的CBT干预。 MOM-Net在NIMH资助的2个随机对照试验(R01MH091199和 R01MH070426)，显示了对抑郁症状的临床显著影响。拟议中的项目 旨在开发和评估一个原型妈妈网教练培训工具的计划，将促进 在社区环境中实施。第一阶段可行性和可用性试验的参与者将包括15人 将参与制定的培训和认证过程的受训人员。在第二阶段，发展 培训工具将完成，然后通过随机对照试验进行评估。总体而言，调查将 有助于关于这一经验支持的干预措施的传播潜力的证据基础， 有可能使更大比例的人口能够获得和受益的适应 从它那里。 拟议的以技术为基础的培训工具应具有高度可持续性，因为它(A)依赖于社区 设置准专业人员提供干预，(B)很可能被证明具有成本效益，因为我们将 利用可提供大规模培训的技术，以及(C)通过利用技术提高保真度 为受训者提供一致的培训体验，包括通过计算机媒体录制的音频 观察客户-教练会议，专家培训师将对其进行审查和评分，以增加 干预实施保真度的可能性。

Project Summary/Abstract Low-income mothers of young children represent a disadvantaged group who are at exceptional risk for depressive syndromes and who have increasingly limited access to mental health services. Despite the availability of efficacious treatments, most depressed persons do not receive treatment. Amongst the many barriers to treatment, several of the most substantial include lack of mental health coverage, difficulties arranging childcare, and the absence of transportation differentially affecting women of low socioeconomic status. For rural women, these difficulties may be compounded by the scarcity of providers within reasonable proximity. In our earlier work, in order to address access barriers, we developed and evaluated Mom-Net, an internet-facilitated CBT intervention for depression tailored to mothers of young children. Mom-Net was developed and evaluated in 2 NIMH-funded randomized controlled trials (R01MH091199 & R01MH070426) that demonstrated clinically significant effects on depressive symptoms. The proposed project is designed to develop and evaluate a prototype Mom-Net coach training tool for the program that will facilitate implementation within community settings. Participants in the Phase I feasibility and usability trial will include 15 trainees who will participate in the developed training and certification process. In Phase II, development of the training tool will be completed and then evaluated via a randomized controlled trial. Overall, the investigation will contribute to the evidentiary base regarding the dissemination potential of this empirically-supported intervention, adaptations to which have the potential to enable a greater proportion of the population to access and benefit from it. The proposed technology-based training tool should be highly sustainable, because it (a) relies on community setting paraprofessional personnel to deliver the intervention, (b) is likely to prove cost-effective given we will utilize a technology that can deliver training at scale, and (c) will improve fidelity by leveraging technology to provide consistent training experiences to trainees and including a computer-mediated audio recorded observation of client-coach sessions that will be reviewed and graded by an expert trainer to increase the likelihood of intervention implementation fidelity.