African-American Social Support Effectiveness Treatment- Partners Alleviating Perinatal Depression (ASSET-PPD)

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Project Summary/Abstract This Exploratory/Developmental Research Grant Program (R21) addresses perinatal depression in African- American (AA) women. AA mothers have a higher risk for perinatal depression than Caucasian women that is attributable to increased socio-environmental stressors. AA women have poor healthcare utilization and compliance with psychiatric treatment compared to Caucasian women. An intervention is required to supplement and support the clinical objectives of the mother’s depression care without requiring the mother’s direct involvement. Fathers are an underutilized resource to reduce the mother’s environmental stress and encourage healthy maternal behaviors. The PI will test the African-American Social Support Effectiveness Treatment- Partners alleviating Perinatal Depression (ASSET-PPD) protocol, a supplemental intervention to maternal perinatal psychiatric treatment. ASSET-PPD will target the fathers’ support of the mothers’ mental health treatment and their active engagement in the family to reduce maternal stress. The ASSET-PPD intervention will be designed to have 4 active modules that address key factors to reduce maternal stress during the prenatal period and 2 postpartum review sessions. ASSET-PPD is designed as individual sessions. The intervention is based on the theoretical models of the stress-generation and cognitive- behavior theories. The modules will be individual sessions constructed to provide training, information, and behavioral assignments to increase fathers’: 1) prenatal and postpartum family involvement; 2) mental health psychoeducation; 3) interparental communication and relationship skills; and 4) balanced division of family tasks. A post-intervention focus group of mothers and fathers will inform the PI of the utility and acceptability of the intervention. In addition, a panel of subject matter experts will be part of an external advisory board to provide feedback on the intervention development. The finalization of the manual will be executed based on the intervention’s performance, and the focus groups’ and advisory board’s feedback. ASSET-PPD will be evaluated in a pilot RCT with 50 cohabitating fathers and AA mothers who will be randomized into the ASSET-PPD intervention or the comparator group. Fathers only will participate in the intervention, and mothers and fathers will complete measures of mental health and parental experiences. Maternal depressive symptoms will be assessed as a primary outcome, and breastfeeding and parent-infant interactions will be assessed as secondary outcomes to inform the utility of the selected measures for a future large-scale RCT. The objective of this protocol is to: 1) assess the acceptability of the intervention to couples; 2) determine the recruitment rate; 3) evaluate the utility of each module’s key components; 4) assess the adequacy of each measure to evaluate the outcomes targeted by the interventions; and 5) determine whether the pilot data warrant a large-scale RCT.