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.

项目总结/摘要 产后抑郁症（PPD）是一种发生在分娩后的非精神病性抑郁发作。PPD原因 新生儿母亲遭受巨大痛苦和残疾，对儿童保育和发展产生不利影响。妇女 来自较低社会经济地位（SES）背景的人特别容易患上PPD。的 产后抑郁症对低社会经济地位母亲的负面影响因获得心理健康的机会有限而进一步加剧 由于结构性障碍和对患有精神健康状况的母亲的污名化，妇女无法获得服务。 具体而言，低SES的非洲裔美国人和拉丁裔母亲寻求心理健康的可能性明显降低 服务比他们的非西班牙裔白色同龄人，使低社会经济地位的非洲裔美国人和拉丁裔家庭更多 易受PPD对健康和发育的不利影响。 解决低收入母亲产后抑郁症的一个有希望的方法是家访。通过提供健康 直接在母亲住所提供护理，家访减少了许多结构和文化障碍 阻止新妈妈参与预防和治疗PPD的服务。先验系统 最终，对PPD通过家访提供服务的有效性进行的审查发现结果好坏参半 结论是没有足够证据支持以家访方式提供服务， 大大改善了产妇的心理健康。然而，最近的两项系统评价仅包括 完全由护士或助产士接生的家访模式。另外两个评论是 在十多年前进行的。从那时起，关于早期癌症的新研究不断涌现， 儿童家访项目。此外，迄今为止发表的审查报告没有确定 与PPD干预的有效家访模式相关的组件。核心知识 成功的关键因素是家访计划更有效地解决产后抑郁症。 因此，仍然需要整合最新的研究，以评估家庭的整体有效性。 PPD的访问模型，并确定预测家访有效性的核心组成部分 降低PPD的方案。 为了确定通过家访解决PPD的总体有效性，研究小组将 系统地搜索、选择和回顾现有的实证研究，评估它们的严谨性和潜在的偏见， 并定量合成效应量。识别预测有效家访的核心组件 项目，干预效果和研究水平特征之间的关联将被分析与Meta数据， 回归分析研究水平特征-潜在的核心组件-包括以下优先级 通过家访计划、家访者类型、家访的持续时间和强度进行PPD干预 访问计划，BIPOC参与者在家访计划中的百分比，以及基线水平和风险 抑郁症的治疗方法