A Randomized Control Trial of a Culturally Relevant Maternal Wellness App to Improve Black Maternal Mental Health Outcomes
一项与文化相关的孕产妇健康应用程序的随机对照试验,以改善黑人孕产妇心理健康结果
基本信息
- 批准号:10593841
- 负责人:
- 金额:$ 20.88万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-27 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdvocacyAdvocateAnxietyAnxiety DisordersAutomobile DrivingBehavioralBiologicalBiological TestingBirthBlack raceBloodC-reactive proteinCOVID-19CREB1 geneCaringChildChildbirthClinicalClinical effectivenessCommunicationCommunication BarriersCommunitiesCommunity NetworksComplicationControl GroupsCoupledDataDiagnosisDiagnosticDiscriminationEducationEtiologyFunctional disorderGene Expression ProfileGenesGestational DiabetesGoalsHealthHealthcareHealthy People 2020InflammationInflammatoryInterventionKnowledgeLawsLightLos AngelesLow Birth Weight InfantMaternal HealthMedicalMental DepressionMental HealthMental Health ServicesMental disordersMinorityMobile Health ApplicationMood DisordersMothersMulti-Institutional Clinical TrialOutcomeParticipantPatientsPerinatalPhysiciansPhysiologicalPopulationPositioning AttributePostpartum PeriodPregnancyPregnancy ComplicationsPregnant WomenPrevalencePrimary Health CareProviderPsyche structurePublic HealthRandomizedRandomized Controlled TrialsRecommendationReportingResearchResearch ProposalsRiskRisk FactorsRoleSmall for Gestational Age InfantSourceSpottingsStressStructureSymptomsTechniquesTelemedicineTestingVisitWell in selfWomanWorkadverse outcomebaseblack patientblack womenclinical carecomparison interventioncultural competencedesigndifferential expressioneffective interventionexperiencefollow-upgroup interventionhealth disparityhealth equityimprovedimproved outcomeinsightjun OncogenemHealthminority patientnovelonline careperinatal mental healthperinatal outcomesperinatal periodphysical conditioningphysical symptomprematureprenatalpreventprospectivepsychoeducationpublic health relevanceracial disparityracismscreeningself helpskillsstandard of carestress managementsupport networksystemic inflammatory responsetranscription factorvirtualwomen of color
项目摘要
Project Summary/Abstract
Perinatal Mood and Anxiety Disorders (PMADs) encompass a range of mental health disorders that occur during
pregnancy and up to one year postpartum. Approximately 13% of women experience PMADs. This rate doubles
for those with adverse perinatal outcomes (APO) and triples in Black women. Recent research points to racism
as one significant source of these health disparities. Cultural adaptations to improve communication with
providers decrease rates of depression in minority patients as well as improve adherence to treatment, insight
and alliance. Discrimination stress and worries about experiencing medical consequences are thought to
increase systemic inflammation, a mechanism known to drive mental and physical symptoms. Inflammation has
been implicated in both PMADs and APO, suggesting a shared underlying etiology. Evidence from our work
suggests that inflammation contributes to the pathophysiology of PMADs. The proposed pilot randomized control
trial will allow us to build on promising preliminary results and identify whether our culturally relevant mobile
Health (mHealth) intervention is effective in improving outcomes among Black pregnant women randomized to
the intervention compared to a control group. The culturally relevant modules include building communication
and self-advocacy skills and provide a support network. The primary objective of this research is to provide
guidance for clinical care of Black women during the perinatal period, with the goal to improve mental
health and physical health outcomes. A secondary goal is to examine novel inflammatory signatures
that change as a function of the intervention to reduce PMADs in this population. As inflammation may be
diagnostic of PMADs, identification of its role may shed light of potential intervention targets and provide critical
knowledge to improve women’s long-term health. PMAD symptoms will be assessed prospectively in 150 Black
pregnant women, half of whom will be randomized to receive the culturally relevant mHealth intervention. We
hypothesize that women in the intervention group will have reduced rates of PMADs and APOs, an increase in
adherence to mental health treatment and will report increased self-advocacy skills, increased communication
with providers, and reduced levels of discrimination related stress. They will also have improved biological risk
indicators including lower circulating C-reactive protein and a transcription profile of differentially expressed
inflammatory genes, marked by a decreased activity of inflammatory transcription factors from blood spots. Given
the high burden of both PMADs and APOs among Black mothers and the numerous consequences on maternal
and child outcomes, it is imperative that we develop and implement effective interventions, and test the biological
mechanisms that might drive these effects. This work is interdisciplinary, building on a network of community
advocates to implement a novel mHealth intervention informed by real world experiences designed to enhance
self-advocacy, reduce stress and prevent adverse outcomes.
项目总结/文摘
项目成果
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{{ truncateString('Eynav Elgavish Accortt', 18)}}的其他基金
A Randomized Control Trial of a Culturally Relevant Maternal Wellness App to Improve Black Maternal Mental Health Outcomes
一项与文化相关的孕产妇健康应用程序的随机对照试验,以改善黑人孕产妇心理健康结果
- 批准号:
10710407 - 财政年份:2022
- 资助金额:
$ 20.88万 - 项目类别:
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