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

创伤性分娩经历（TBE）是产后创伤后应激障碍的一个未被充分认识的风险 （p-PTSD），抑郁和焦虑，这有助于显着的社会，医疗和经济负担。两 TBE和产后精神病理学不成比例地经历了服务不足和少数民族 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， 全面的、以优势为基础的方法，以明确的影响机制来照顾怀孕的人。 性格乐观（DO）是一个弹性因素，通过它我们可以在孕产妇健康方面取得进展， 与广泛的心理健康益处有关，包括预防和治疗PTSD 在非妊娠人群中。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，以加强复原力和积极影响健康和健康公平。但是，在这方面， 这种方法尚未在围产期人群中使用。 在这个项目中，我们提出了一个随机临床试验，比较使用现有的，公平为重点，围产期 正念电话应用程序（预期），以常规护理怀孕的人与低DO。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）探索对 乐观和其他弹性机制在怀孕的经验和结果。 本试验的结果将支持计划的II型混合实施-有效性随机试验， 减少TBE和p-PTSD，并通过改善DO减少健康差异。

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.