Mindfulness, Optimism and Resilience for Perinatal Health and Equity (MORPHE) Trial

创伤性出生经历(TBE)是产后创伤后应激障碍的未被重视的风险 精神创伤后应激障碍(P-PTSD)、抑郁和焦虑，造成重大的社会、医疗和经济负担。两者都有 与产后精神病理学不成比例的是，缺乏服务和被小型化 这进一步扩大了产妇保健成果方面的已知差距。我们迫切需要创新， 整体的、以力量为基础的方法，以明确的影响机制照顾孕妇。 性格乐观(DO)是一个弹性因素，我们可以通过它来推动产妇健康，以及 与广泛的精神健康益处有关，包括预防和治疗创伤后应激障碍 在非怀孕人群中。正念干预在改善DO方面显示出希望，因此可能是一种 跨诊断方法，以增强复原力并积极影响健康和健康公平。然而， 这种方法还没有在围产期人群中使用。 在这个项目中，我们提出了一项随机临床试验，比较了现有的、关注公平的围产期 正念电话应用(预期)对低氧孕妇的常规护理。100 参与者将被随机分组，以评估1)数字正念的可行性和可接受性 干预，2)预期对DO、TBE和p-PTSD的影响，以及3)探讨 怀孕经历和结局中的乐观和其他弹性机制。 这项试验的结果将支持计划中的第二类混合实施-有效性随机试验 减少TBE和p-PTSD，并通过改善DO来减少健康差距。

Traumatic birth experience (TBE) is an underappreciated risk for postpartum post-traumatic stress disorder (p-PTSD), depression and anxiety, which contribute to significant social, medical, and economic burden. Both TBE and postpartum psychopathology are disproportionately experienced by underserved and minoritized populations, further widening the known gap in maternal health outcomes. We urgently need innovative, wholistic, strengths-based approaches to care for pregnant people with clear mechanisms of impact. Dispositional optimism (DO) is a resilience factor by which we can move the needle on maternal health, and has been associated with wide-ranging mental health benefits, including prevention and treatment of PTSD in non-pregnant populations. Mindfulness interventions show promise in improving DO and thus may be a transdiagnostic approach to bolstering resilience and positively impact health and health equity. However, this approach has not been utilized in a perinatal population. In this project, we propose a randomized clinical trial comparing use of an existing, equity-focused, perinatal mindfulness phone application (Expectful) to routine care for pregnant individuals with low DO. 100 participants will be randomized in order to assess 1) feasibility and acceptability of the digital mindfulness intervention, 2) impact of Expectful on DO, TBE and p-PTSD, and 3) explore perspectives on the role of optimism and other resilience mechanisms in pregnancy experience and outcomes. Results from this trial will support a planned type II hybrid implementation-effectiveness randomized trial to reduce TBE and p-PTSD, and reduce health disparities via improvements in DO.