Maternal Depression and Early Head Start

描述（由候选人提供）：母亲抑郁症是母亲和孩子发病率的重要来源。这份K23申请概述了一项指导的5年教育和研究计划，致力于开发和研究早期开端（EHS）中母亲抑郁症的自我管理支持系统，EHS是一项联邦资助的低收入家庭早期儿童发展计划。以慢性护理模式为基础的干预，将包括通过标准化的工具识别有抑郁症状的母亲，以及一个涉及动机增强和问题解决治疗的病例管理系统。通过这些策略——后者是针对抑郁症本身的循证治疗——ehs个案工作者将把母亲与进一步的循证心理健康服务联系起来，如认知行为治疗和药物管理，并提供后续的持续支持和重新评估。研究计划的具体目标是：1。对EHS母亲进行定性访谈，以确定将自己的心理健康问题作为子女学前教育经历的一部分的态度范围；2. 与EHS个案工作者进行焦点小组讨论，了解参与这类个案管理系统的个人和制度障碍；3. 通过为期9个月的试点干预，制定病例管理方案的细节；4. 对该系统进行准实验研究，以测试其对EHS母亲接受抑郁服务、抑郁症状、社会功能、母亲与子女的教学互动质量和儿童保健利用的影响。候选人将获得定性和定量研究方法、行为干预设计、促进心理健康的系统方法和亲子互动分析方面的经验。本项目所获得的信息和经验将用于设计一项纵向随机对照试验，以研究该系统对母亲抑郁症状及其子女发育结局的影响。

DESCRIPTION (provided by candidate): Maternal depression is a source for substantial morbidity for both mother and child. This K23 application outlines a mentored 5-year education and research plan, devoted to developing and studying a self- management support system for maternal depression in Early Head Start (EHS), a federally funded early child development program for low income families. The intervention, based on the Chronic Care Model, will involve the identification of mothers with depressive symptoms through standardized instruments, and a case-management system that involves motivational enhancement and problem solving therapy. Through these strategies-the latter of which is an evidence-based treatment for depression in and of itself-EHS caseworkers will link mothers to further evidence-based mental health services, such cognitive behavioral therapy and medication management, and provide subsequent ongoing support and reassessment. The specific aims of the research plan are to: 1. conduct qualitative interviews with EHS mothers to determine the range of attitudes to having their own mental health addressed as part of their children's preschool experience; 2. conduct focus groups with EHS caseworkers to learn the personal and institutional barriers to participating in this type of case-management system; 3. develop, through a 9-month pilot intervention, the details of the case-management protocol; 4. conduct a quasi-experimental study of the system to test its effect on EHS mothers' receipt of services for depression, depressive symptoms, social functioning, quality of maternal teaching interactions with their children, and child health care utilization. The candidate will gain experience in qualitative and quantitative research methods, behavioral intervention design, systems approaches to mental health promotion, and analysis of parent-child interaction. Information and experience gained from this project will be used to design a longitudinal randomized controlled trial to study the effect of this system on both mothers' depressive symptoms and their children's developmental outcomes.