Pevention of Depression among Mothers of Young Children with Developmental Delay

描述（由申请人提供）：作为一名护士，在我的职业生涯中，我看到了抑郁症对母亲和孩子的影响。抑郁母亲的孩子有可能出现各种各样的身体、认知和情感问题。针对弱势家庭的社区方案始终将孕产妇抑郁症视为对孕产妇和儿童结局产生负面影响的一个因素。这些女性被发现患抑郁症的风险增加。因此，识别和治疗抑郁的母亲不仅是帮助受影响妇女的机会，也是改善其子女发展和行为结果的机会。拟议的K-应用程序旨在建立候选人作为一个独立的研究人员，其工作重点是建立以社区为基础的预防干预措施，以解决谁是参加早期干预（El），一个全国性的家庭为基础的计划，为大约280，000有风险的儿童出生到三个幼儿的母亲中的孕产妇抑郁症状。我将利用该奖项1）在孕产妇情感障碍方面奠定坚实的基础; 2）提高我对预防抑郁症和自我管理的解决问题方法的理解; 3）在设计，适应和测试方面发展专业知识以社区为基础的预防性心理健康干预措施。虽然存在有效的抑郁症预防性心理社会治疗，但在专门针对患有发育和其他慢性健康状况的婴儿和儿童的母亲的家庭计划竞赛中，没有一种治疗方法被提供和评估。计划进行三项研究，以适应和测试一个特定的解决问题的干预措施，解决问题的治疗（PST），以防止抑郁症状的发作和复发的母亲的孩子参加了马萨诸塞州的EI计划。我将使用定性的方法来探讨产妇和工作人员的看法，解决产妇的心理健康在萨尔瓦多。第二项研究采用定性和定量方法，将使PST适应厄尔尼诺环境。最后一个项目将是一项准实验研究，其中6名受过PST培训的El个案工作者将治疗24个家庭，以测试PST对影响母亲抑郁症状的有效性，该研究的主要结果，以及母亲的社会功能，育儿压力和母婴互动的质量。本项目将用于定义设计后续的、具有适当把握度的随机分组临床试验所需的方法学参数。我的目标是使用从这些研究中获得的信息来设计和寻求纵向集群RCT的资金，以验证我的假设，即在El计划中整合基于证据的预防性心理健康干预可以减少高危母亲的抑郁症状负担。

DESCRIPTION (provided by applicant): As a nurse, throughout my career, I have seen the effects of depression on both mothers and children. Children of depressed mothers are at risk for a vast range of poor physical, cognitive, and emotional problems. Community-based programs that target vulnerable families consistently identify maternal depression as a factor that negatively impacts maternal and child outcomes. These women have been found to be an increased risk for depression. Therefore, identifying and treating depressed mothers represents an opportunity not only to help the women affected, but also to improve developmental and behavioral outcomes for their children. The proposed K-application is designed to establish the candidate as an independent researcher whose work focuses on building community-based preventive interventions to address maternal depressive symptoms among mothers of young children who are enrolled in Early Intervention (El), a national home based program that serves approximately 280,000 at-risk children birth to three. I will use the award to 1) develop a strong foundation in maternal affective disorders; 2) enhance my understanding of problem solving approaches to depression prevention and self-management; and 3) develop expertise in the design, adaptation, and testing of community-based preventive mental health interventions. While effective preventative psychosocial treatments for depression exist, none have been delivered and evaluated in the contest of a home-based program specifically for mothers of infants and children with developmental and other chronic health conditions. Three studies are planned to adapt and test a specific problem solving intervention, Problem Solving Treatment (PST), to prevent the onset and reoccurrence of depressive symptoms among mothers whose children are enrolled in the Massachusetts El Program. I will use qualitative methods to explore both maternal and staff perceptions about addressing maternal mental health in El. The second study, using both qualitative and quantitative methods, will adapt PST to the El environment. The last project will be a quasi-experimental study, in which 6 El case workers, trained in PST, will treat 24 families, to test the effectiveness of PST to impact maternal depressive symptoms, the study's primary outcome, as well as maternal social function, parenting stress, and quality of maternal-child interactions. This project will be used to define the methodological parameters necessary to design a subsequent; appropriately powered cluster randomized clinical trial. My goal is use the information gained from these studies to design and seek funding for a longitudinal cluster RCT to test my hypothesis that integrating an evidenced-based preventive mental health intervention in El programs can decrease the burden of depressive symptoms among at-risk mothers.