MomNet: Development of a Coach-Training Program for an Empirically Supported, Guided ehealth Intervention for Depressed Mothers

项目概要/摘要 经济上处于不利地位的幼儿母亲经历不成比例的高抑郁率 这些人往往没有症状，但由于工具和心理障碍，他们往往得不到治疗。缓解 母亲抑郁症与养育行为和儿童功能的改善有关，这表明， 治疗母亲抑郁症有可能改善几代人的结果。以提高访问 为了在这一人群中进行循证抑郁症治疗，我们开发了Mom-Net，一个教练指导的电子健康 对患有抑郁症的幼儿母亲进行干预。”“ 与无指导的干预措施相比，干预措施产生的参与度和效力要高得多。 Mom-Net在两项针对低收入抑郁母亲的对照试验中证明了其有效性， 由专业妈妈网培训师亲自进行的教练培训所产生的有效性。增加妈妈网 在第一阶段，我们的SBIR工作重点是开发和评估远程教练培训原型 为辅助专业人员，复制面对面的培训计划。远程教练培训包括自我指导 在线课程、与专业培训师的网络研讨会现场练习课程以及认证过程。年底 在第一阶段，我们获得了用于Mom-Net混合、第二类实施效果研究的资金 （R 01 MH 120237），导致第1阶段原型快速扩展为完整的远程培训 作为审判的必要组成部分。目前的第二阶段项目建立在R 01工作的基础上， 积极评价并成功实现第一阶段项目目标。第二阶段的目标是：1）建立一个远程列车- 培训师计划和管理门户，允许社区设置内部培训和监控他们的 自己的工作人员; 2）评估培训师培训计划的主要成果，完成会议，妈妈网 内容和教练技能知识，教学策略知识，以及观察到的培训师使用 教学策略; 3）检查两个Mom-Net教练培训选项之间的有效性等效性， 在33家领先机构中进行的随机试验。每个机构有四名工作人员（n = 132）将担任 准专业教练学员，随机接受外部专业教练培训师或 机构内的培训师。将在课程完成、Mom-Net内容掌握、 和忠诚的教练技巧。拟议的项目，最终在培训规模，提供两个培训 选择，将使Mom-Net商业化和更广泛的传播，这反过来将有助于 更多地接触到弱势、得不到充分服务的患有抑郁症的母亲群体。

Project Summary/Abstract Economically disadvantaged mothers of young children experience disproportionately high rates of depressive symptoms, yet often do not receive treatment due to instrumental and psychological barriers. Remission of maternal depression relates to improvements in both parenting behavior and child functioning, suggesting that treatment of maternal depression has the potential to improve outcomes across generations. To increase access to evidence-based depression treatment in this population, we developed Mom-Net, a coach-guided, e-health intervention for depressed mothers of young children. Mom-Net is coach-guided, given evidence that guided interventions produce significantly higher levels of engagement and effectiveness than unguided interventions. Mom-Net has demonstrated effectiveness in two controlled trials with low-income depressed mothers, with effectiveness derived from in-person coach training by a professional Mom-Net trainer. To increase Mom-Net dissemination, our Phase I SBIR efforts focused on developing and evaluating remote coach-training prototypes for paraprofessionals, replicating the in-person training program. Remote coach training includes self-guided online sessions, webinar live practice sessions with a professional trainer, and a certification process. At the end of Phase I, we received funding for a Mom-Net hybrid, type II implementation-effectiveness study (R01MH120237), resulting in quick expansion of the Phase 1 prototypes into a completed remote training process as a necessary component of the trial. The current Phase II project builds upon the R01 effort and a positive evaluation and successful realization of Phase I project goals. Phase II aims to: 1) create a remote Train- the-Trainer program and Administrative Portal, allowing community settings to internally train and monitor their own staff; 2) evaluate the Train-the-Trainer program on the primary outcomes of session completion, Mom-Net content and coaching skills knowledge, teaching strategy knowledge, and fidelity in observed trainer use of teaching strategies; 3) examine effectiveness equivalence between the two Mom-Net coach training options in a randomized trial in 33 Head Start agencies. Four staff within each agency (n = 132) will serve as paraprofessional coach trainees, randomized to be trained by either the external professional coach trainer or the trainer within the agency. Equivalency will be evaluated on session completion, Mom-Net content mastery, and fidelity in coaching skills. The proposed project, culminating in training at scale by offering two training options, will enable commercialization and broader dissemination of Mom-Net which, in turn, will contribute to greater access to a vulnerable, underserved population of mothers experiencing depressive symptoms.