A Systematic Review and Meta-analysis on the Effectiveness of Home Visiting Programs on Postpartum Depression

家访计划对产后抑郁症有效性的系统回顾和荟萃分析

• 批准号: 10629114
• 负责人: Michelle (Micki) E Washburn
• 金额: $ 9.03万
• 依托单位: UNIVERSITY OF TEXAS ARLINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10629114
• 关键词: Systematic; Review; Meta; analysis; Effectiveness

PROJECT SUMMARY/ABSTRACT Postpartum depression (PPD) is a non-psychotic depressive episode occurring after childbirth. PPD causes enormous suffering and disability in new mothers, negatively impacting child care and development. Women from lower socioeconomic status (SES) backgrounds are particularly vulnerable to developing PPD. The negative impact of PPD on low-SES mothers is further compounded by limited access to mental health services due to structural barriers and stigma toward mothers experiencing mental health conditions. Specifically, low SES African American and Latina mothers are significantly less likely to seek mental health services than their non-Hispanic white peers, making low-SES African American and Latina families more vulnerable to the adverse health and developmental impacts of PPD. One promising approach to addressing PPD among low-income mothers is home visiting. By delivering health care directly to mothers in their residence, home visiting reduces many of the structural and cultural barriers preventing new mothers from engaging with services for the prevention and treatment of PPD. Prior systematic reviews on the effectiveness of service delivery via home visiting for PPD found mixed results, ultimately concluding that there was insufficient evidence to support that the home visiting approach for service delivery significantly improves maternal mental health. However, the two most recent systematic reviews only included home visiting models that were delivered exclusively by nurses or midwives. The other two reviews were conducted more than ten years ago. Since then, there has been a proliferation of new research on early childhood home visiting programs. Moreover, the reviews published to date have not identified core components associated with effective home visiting models for PPD intervention. Knowledge of core components for success is critical for home visiting programs to address PPD more effectively and efficiently. Accordingly, there remains a need to integrate the latest research to evaluate the overall effectiveness of home visiting models on PPD and to identify core components predictive of the effectiveness of home visiting programs in reducing PPD. To determine the overall effectiveness of addressing PPD via home visiting, the research team will systematically search, select, and review existing empirical studies, evaluate them for rigor and potential bias, and quantitatively synthesize the effect sizes. To identify core components predictive of effective home visiting programs, associations between intervention effect and study-level characteristics will be analyzed with meta- regression analysis. Study-level characteristics—the potential core components— include the priority given to PPD intervention by a home visiting program, types of home visitors, the duration and intensity of a home visiting program, percentage of BIPOC participants in a home visiting program, and baseline level of and risk for depression among service recipients.

项目摘要/摘要 产后抑郁症（PPD）是分娩后发生的非精神抑郁发作。 PPD原因 新妈妈的巨大痛苦和残疾，对育儿和发展产生负面影响。女性 从较低的社会经济地位（SES）背景特别容易受到发展PPD的影响。这 PPD对低SES母亲的负面影响进一步加剧了对心理健康的机会 由于结构性障碍和对经历精神健康状况的母亲的污名所致的服务。 具体来说，低SES非裔美国人和拉丁裔母亲寻求心理健康的可能性较小 服务比非西班牙裔白人同龄人，使低名的非裔美国人和拉丁裔家庭更多 容易受到PPD的不利健康和发展影响。 在低收入母亲中解决PPD的一种承诺方法是在家访问。通过提供健康 直接照顾住房中的母亲，访问的家庭降低了许多结构和文化障碍 防止新母亲参与预防和治疗PPD的服务。先前的系统 评论通过访问PPD的家庭访问的服务提供有效性，最终发现了不同的结果 结论是，没有足够的证据支持家庭访问服务的方法 显着改善物质心理健康。但是，两个最新的系统评论仅包括 由护士或助产士专门提供的家庭访问模型。其他两个评论是 十多年前进行。从那以后，关于早期的新研究泛滥 童年的家庭访问计划。此外，迄今为止发表的评论尚未确定核心 与有效的PPD干预模型相关的组件。核心知识 成功的组件对于家庭访问计划至关重要，以更有效，有效地解决PPD。 彼此之间，仍然需要整合最新的研究以评估家庭的整体有效性 在PPD上访问模型，并确定核心组件预测家庭访问有效性 减少PPD的程序。 为了确定通过家庭访问解决PPD的总体有效性，研究团队将 系统地搜索，选择和审查现有的经验研究，对它们进行严格和潜在的偏见评估， 并定量合成效果大小。确定预测有效家庭访问的核心组件 计划，干预效果与研究水平特征之间的关联将通过元分析 回归分析。研究级特征（潜在的核心组成部分）包括优先级 家庭访问计划的PPD干预，家庭访客类型，家庭的持续时间和强度 访问计划，家庭访问计划中的BIPOC参与者的百分比以及基线水平和风险 服务接受者之间的抑郁症。