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

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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.