Advancing Insight into Maternal Social Support (AIMSS)

摘要 产后情绪障碍(PPMD)影响着8%-13%的新妈妈，另有16%-23%的新妈妈情绪高涨 在婴儿出生的第一年期间的症状。对PPMD的干预措施多种多样，包括 药物和社会心理治疗，如社会支持。然而，现有的关于优势的研究 社会支持方案的范围仅限于产后阶段。因此，社会支持的好处 怀孕期间的计划还没有建立，对在什么情况下 这些计划可能会影响PPMD。中心妊娠是一种基于群体的产前护理模式，并展示了 与产前照常护理(CAU)相比，孕产妇和婴儿的健康结果是积极的。它针对的是 许多障碍通常阻碍产前心理健康干预，是一种低成本且容易传播的 模型，并且在不同的样本中具有很高的患者满意度。然而，记录的结果仅限于 分娩结果(例如，早产率降低、低出生体重降低、母乳喂养增加)和 孕期糖尿病和吸烟等产前产妇的身体健康。检验这一效果的研究 关于产后心理健康的研究很少，而且受限于样本量小，缺乏产后心理健康 评估，以及精神健康结果的狭隘可操作性(例如，仅限于抑郁症)。建议数 该项目将通过以下目标检查精神健康的好处，以解决这些限制：1)使用 预先存在的数据集，以确定在什么情况下中心妊娠模型与CAU会产生影响 母体抑郁结局；2)收集新数据以检查影响，作为对相关的临床干预 母亲结局(例如，PPMD；PPMD和早期育儿的交互影响)，同时 观察和收集关于实施的信息以便a)使临床疗效效用最大化(即， 侧重于内部有效性)，并检查b)临床有效性(即概括性)，以及c)实施 成果(即可接受性、可行性)，以促进可持续性和可扩充性作为有效的 PPMD的干预和预防策略；以及3)加强我们的研究环境和参与 本科生合作研究，同时指导和指导他们的研究概念和 流程(例如，研究方法、参与者招募、道德和专业标准、数据 收集和分析，以及学术生产力)，因为它们与中心怀孕模式有关， 心理健康，以及相关的结果。本研究的成果将对现有的知识库做出贡献 通过促进对与产妇心理健康相关的社会支持干预措施的理解，并揭示 有针对性的预防和干预计划的切入点，以改变母亲情绪障碍的风险 在整个孕期和产后期间。此外，注重临床有效性和实施 成果将支持涉及以群体为基础的社会支助的干预措施的可持续性和可扩展性。

ABSTRACT Postpartum mood disorders (PPMD) affect 8-13% of new mothers, with another 16-23% experiencing elevated symptomology throughout the infant’s first year of life. A variety of interventions for PPMD exist, including pharmacological and psychosocial treatments such as social support. However, existing research on advantages of social support programs has been limited to the postpartum period only. As such, benefits of social support programs during pregnancy have not been established, and little is known about the conditions under which these programs may affect PPMD. CenteringPregnancy is a group-based prenatal care model with demonstrated positive maternal and infant health outcomes when compared to prenatal care-as-usual (CAU). It addresses many barriers commonly impeding prenatal mental health interventions, is a low-cost and easily disseminated model, and has high patient satisfaction across diverse samples. However, documented outcomes are limited to birth outcomes (e.g., reduced preterm birth rates, reduced low birth-weight, increased breastfeeding) and prenatal maternal physical health such as gestational diabetes and smoking. The research examining the effect on postpartum mental health is scant and limited by small sample sizes, absence of postpartum mental health assessments, and narrow operationalization of mental health outcomes (e.g., depression only). The proposed project will address these limitations by examining mental health benefits through the following Aims: 1) Use a pre-existing dataset to determine under what conditions the CenteringPregnancy model versus CAU affects maternal depression outcomes; 2) Gather new data to examine impacts as a clinical intervention on relevant maternal outcomes (e.g., PPMD; interaction effects of PPMD and early parenting), while simultaneously observing and gathering information on implementation in order to a) maximize clinical efficacy utility (i.e., focusing on internal validity), and examine b) clinical effectiveness (i.e., generalizability), and c) implementation outcomes (i.e., acceptability, feasibility) in order to facilitate sustainability and scalability as an effective intervention and prevention strategy for PPMD; and 3) Strengthen our research environment and engage undergraduate students in collaborative research while mentoring and instructing them in research concepts and processes (e.g., research methodology, participant recruitment, ethical and professional standards, data collection and analysis, and scholarly productivity) as they relate to the CenteringPregnancy model, maternal mental health, and relevant outcomes. The results of this research will contribute to the existing knowledge base by advancing understanding of social support interventions relevant to maternal mental health and revealing targeted points of entry for prevention and intervention programs to alter maternal mood disorder risk during pregnancy and throughout the postpartum period. Further, the focus on clinical effectiveness and implementation outcomes will support sustainability and scalability of interventions involving group-based social support.