The Development of PATH, a Program to Support NICU Parent Mental Health Through the Transition from Hospital to Home

PATH 的开发，一个通过从医院到家庭的过渡来支持 NICU 家长心理健康的计划

• 批准号: 10615792
• 负责人: Susanne Klawetter
• 金额: $ 16.58万
• 依托单位: PORTLAND STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10615792
• 关键词: Accident and Emergency department; Acute; Address; Administrator; Adoption; Affect; Anxiety; Award; Awareness; Behavior Therapy; Biometry; Birth; Breast Feeding; COVID-19 pandemic; Caring; Case Series; Child; Child Care; Child Development; Child Health; Child Rearing; Clinical; Cognitive; Collaborations; Community Mental Health Services; Data; Data Collection; Development; Doctor of Philosophy; Effectiveness; Eligibility Determination; Ensure; Family; Funding; Goals; Health Personnel; Health Services Research; Healthcare Systems; Home; Hospitalization; Hospitals; Improve Access; Infant; Infant Health; Institution; Learning; Logistics; Maintenance; Maternal Mortality; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentored Clinical Scientist Development Program; Mentorship; Methods; Neonatal Intensive Care Units; Nurses; Outcome; Parents; Perinatal; Post-Traumatic Stress Disorders; Premature Infant; Prevalence; Preventive healthcare; Primary Care; Procedures; Program Acceptability; Public Health Informatics; Qualitative Research; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Activity; Research Personnel; Review Committee; Risk; Rural Health; Self Efficacy; Services; Site; Social Workers; Statistical Methods; Structure; Suicide; Symptoms; Testing; Time; Training; Training Activity; Transportation; United States Preventative Services Task Force; Universities; Work; acceptability and feasibility; behavioral outcome; care systems; career; clinical practice; clinically significant; depressive symptoms; effectiveness/implementation trial; experience; health care service; health economics; health information technology; high risk; hospital readmission; implementation science; improved; innovation; meetings; multidisciplinary; perinatal health; pilot test; pragmatic implementation; primary care provider; professor; programs; randomized trial; rurality; screening; skills; social stigma; socioeconomics; success; telehealth; tenure track; urgent care

Project Summary/Abstract This application for a K08 Award includes training and research activities that support my transition to an independent mental health services researcher focused on improving services for parents with mental illness. I am a PhD-trained clinical social worker and tenure-track Assistant Professor at Portland State University, with a background in providing mental health services to parents and families. I am completing an Institutional K12 Award to study the mental health needs of parents in the neonatal intensive care unit (NICU). This K08 Award will build off my qualitative research and advance my research career by providing protected time, mentorship, and structured support to 1) learn implementation science methods, 2) increase my understanding of integrated mental health services, 3) obtain skills to conduct rigorous randomized control trials, including statistical methods necessary to analyze results, and 4) gain the skills necessary to become a leader in the field of parent mental health services research. My multidisciplinary mentorship team brings expertise in deployment-focused and participatory methods, health services research, implementation science, parent mental health research, randomized control trials, health economics, health informatics, rural health, and biostatistics. Parents of NICU-hospitalized preterm infants are at extremely high risk for mental health conditions with potentially devastating consequences. Yet, perinatal systems of care do not systematically support NICU parent mental health. The U.S. Preventive Services Task Force and state-level Maternal Mortality Review Committees have called upon perinatal systems of care to prioritize parent mental health. The objectives of this proposal are to develop and pilot test a telehealth-based mental health screening and engagement program that supports parents as they transition from the NICU to home. The program will use a stepped-care approach to screen parents for depression, anxiety, and PTSD; provide a brief behavioral intervention to those who screen as having at least a low risk of these conditions; and provide a warm hand-off to community mental health services for those at medium to high risk. We will achieve the study objectives by meeting 3 specific aims: 1) to use a RE-AIM framework to develop the program in collaboration with former NICU parents and NICU and primary care stakeholders; 2) to conduct an iterative case series to work out practical implementation details and logistics, refine the mental health screening and engagement program, and qualitatively assess purported mechanisms of action; and 3) to conduct a pilot randomized control trial to assess the program's acceptability and feasibility; to test its preliminary efficacy in targeting mental health self- efficacy and other potential mechanisms of action; and to better understand facilitators to adoption, implementation, and maintenance. The proposed activities will provide preliminary data and allow for the refinement of data collection procedures necessary for an R01 application to conduct a Type 1 hybrid effectiveness/implementation trial in multiple NICUs across the U.S.

项目总结/摘要 K 08奖的申请包括培训和研究活动，以支持我过渡到 独立的心理健康服务研究人员专注于改善为患有精神疾病的父母提供的服务。我 我是一名接受过博士培训的临床社会工作者，也是波特兰州立大学的终身助理教授， 为父母和家庭提供心理健康服务的背景。我正在完成机构K12 研究新生儿重症监护病房（NICU）父母的心理健康需求奖。K 08奖 将建立我的定性研究，并通过提供受保护的时间，导师， 和结构化的支持，以1）学习实施科学方法，2）增加我对 综合心理健康服务，3）获得进行严格随机对照试验的技能，包括 必要的统计方法来分析结果，和4）获得必要的技能，成为一个领导者， 父母心理健康服务研究领域。我的多学科导师团队带来了专业知识， 以部署为中心的参与式方法，卫生服务研究，实施科学，父母 心理健康研究，随机对照试验，卫生经济学，卫生信息学，农村卫生， 生物统计学NICU住院早产儿的父母处于极高的心理健康风险中 具有潜在破坏性后果的条件。然而，围产期护理系统并没有系统地 支持NICU父母心理健康。美国预防服务工作队和州一级的孕产妇 死亡率审查委员会呼吁围产期护理系统优先考虑父母的心理健康。的 该提案的目标是开发和试点测试基于远程医疗的心理健康筛查， 参与计划，支持父母从新生儿重症监护室过渡到家里。该程序将使用 逐步护理的方法来筛选父母的抑郁症，焦虑，和创伤后应激障碍;提供一个简短的行为 对那些筛查出至少有较低风险的人进行干预;并提供温暖的交接 社区心理健康服务，为那些处于中度至高度风险。我们会透过以下方法达致研究目标： 满足3个具体目标：1）使用RE-AIM框架与前 NICU父母和NICU和初级保健利益相关者; 2）进行迭代病例系列， 切实可行的实施细节和后勤，完善心理健康筛查和参与计划， 并定性评估声称的作用机制; 3）进行一项初步随机对照试验， 评估该计划的可接受性和可行性;测试其针对心理健康自我的初步功效， 有效性和其他潜在的行动机制;以及为了更好地了解采用的促进者， 实施和维护。拟议的活动将提供初步数据并允许 完善R 01应用程序进行1型混合所需的数据收集程序 在美国多个NICU中进行的有效性/实施试验

项目成果

Comparisons of Three Measures of Maternal Engagement Activities in the Neonatal Intensive Care Unit.

新生儿重症监护病房母亲参与活动的三种措施的比较。

• DOI: 10.1097/nnr.0000000000000582
• 发表时间: 2022-05-01
• 期刊: NURSING RESEARCH
• 影响因子: 2.5
• 作者: Greenfield, Jennifer C.;Weikel, Blair W.;Bourque, Stephanie L.;Hwang, Sunah S.;Klawetter, Susanne;Roybal, Kristi L.;Palau, Mauricio A.;Scott, Jessica;Shah, Pari;Brown, Kyria;Neu, Madalynn
• 通讯作者: Neu, Madalynn

"We Experience What They Experience": Black Nurses' and Community Health Workers' Reflections on Providing Culturally Specific Perinatal Health Care.

• DOI: 10.1177/10436596221130798
• 发表时间: 2023-01
• 期刊: JOURNAL OF TRANSCULTURAL NURSING
• 影响因子: 2.1
• 作者: Hunte, Roberta;Mehrotra, Gita R.;Klawetter, Susanne
• 通讯作者: Klawetter, Susanne

"All these people saved her life, but she needs me too": Understanding and responding to parental mental health in the NICU.

• DOI: 10.1038/s41372-022-01426-1
• 发表时间: 2022-11
• 期刊: JOURNAL OF PERINATOLOGY
• 影响因子: 2.9
• 作者: Klawetter, Susanne;Cetin, Nazan;Ilea, Passion;McEvoy, Cindy;Dukhovny, Dmitry;Saxton, Sage N.;Rincon, Monica;Rodriguez-JenKins, Jessica;Nicolaidis, Christina
• 通讯作者: Nicolaidis, Christina

Novel perinatal medical-legal partnership development and pilot implementation to address health-harming legal needs.

新型围产期医疗法律伙伴关系的发展和试点实施，以满足危害健康的法律需求。

• DOI: 10.1038/s41372-023-01829-8
• 发表时间: 2024
• 期刊: Journal of perinatology : official journal of the California Perinatal Association
• 作者: Gievers,Ladawna;Mutrie,Lauren;Klawetter,Susanne
• 通讯作者: Klawetter,Susanne

NICU Visitation Time and Adherence to Safe Sleep Practices Among Mothers of Very Preterm Infants.

• DOI: 10.1097/anc.0000000000001066
• 发表时间: 2023-08-01
• 期刊: ADVANCES IN NEONATAL CARE
• 影响因子: 1.7
• 作者: Hwang, Sunah S.;Weikel, Blair W.;Palau, Mauricio A.;Greenfield, Jennifer C.;Klawetter, Susanne;Neu, Madalynn;Roybal, Kristi L.;Scott, Jessica;Shah, Pari;Bourque, Stephanie L.
• 通讯作者: Bourque, Stephanie L.