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

项目摘要/摘要 经济上处于不利地位的幼儿母亲患抑郁症的几率高得不成比例 有症状，但往往由于工具障碍和心理障碍而得不到治疗。减刑 母亲抑郁与育儿行为和孩子功能的改善有关，这表明 对母亲抑郁的治疗有可能改善世代之间的结果。要增加访问权限 为了在这一人群中进行循证的抑郁症治疗，我们开发了一款由教练指导的电子健康软件Mom-Net 对有年幼子女的抑郁母亲的干预。妈妈网是由教练指导的，有证据表明指导 与无指导的干预措施相比，干预措施的参与度和有效性要高得多。 MOM-Net在两项针对低收入抑郁母亲的对照试验中证明了有效性， 由专业的妈妈网培训师进行的面对面教练培训带来的效果。增加妈妈网 通过传播，我们的第一阶段SBIR工作重点是开发和评估远程教练员培训原型 对于辅助专业人员，复制面对面培训计划。远程教练培训包括自我指导 在线课程、由专业培训师主持的网络研讨会现场练习课程，以及认证流程。在最后 在第一阶段，我们获得了母亲-网络混合体第二类实施-有效性研究的资金 (R01MH120237)，导致将阶段1原型快速扩展为已完成的远程培训 程序作为审判的一个必要组成部分。目前的第二阶段项目建立在R01努力和一个 积极评价并成功实现一期项目目标。第二阶段的目标是：1)创建远程列车- -Trader计划和管理门户，允许社区设置内部培训和监控其 自己的工作人员；2)根据完成培训的主要结果来评估培训员培训方案，妈妈网 内容和教练技能知识，教学策略知识，以及观察培训师使用的忠诚度 教学策略；3)检验两种妈妈网教练培训方案的有效性等价性 在33个Head Start机构中进行的随机试验。每个机构内的四名工作人员(n=132)将担任 准职业教练实习生，随机接受外部专业教练培训或 该机构内部的培训师。等价性将根据会话完成、妈妈网内容掌握情况、 以及执教技巧的忠诚度。拟议的项目，最终通过提供两个培训来进行大规模培训 选择，将使妈妈网的商业化和更广泛的传播，这反过来将有助于 更多地接触到患有抑郁症状的脆弱、服务不足的母亲群体。

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.