Pevention of Depression among Mothers of Young Children with Developmental Delay

描述(申请人提供)：作为一名护士，在我的整个职业生涯中，我目睹了抑郁症对母亲和孩子的影响。抑郁母亲的孩子面临着一系列糟糕的身体、认知和情感问题的风险。以弱势家庭为对象的社区方案一贯认为，产妇抑郁是对母婴结局产生负面影响的一个因素。研究发现，这些女性患抑郁症的风险更高。因此，识别和治疗抑郁的母亲不仅是帮助受影响的妇女的机会，也是改善她们孩子的发育和行为结果的机会。拟议的K-应用程序旨在将候选人确立为独立研究人员，其工作重点是建立基于社区的预防干预措施，以解决参加早期干预(EL)的幼儿的母亲的母亲抑郁症状。EL是一个全国性的家庭计划，为大约28万名出生到三岁的高危儿童提供服务。我将利用这个奖项1)在母性情感障碍方面奠定坚实的基础；2)增进我对抑郁症预防和自我管理的问题解决方法的理解；3)发展社区预防性心理健康干预措施的设计、适应和测试方面的专业知识。虽然存在有效的预防抑郁症的心理社会治疗，但在专门针对婴儿母亲和患有发育障碍和其他慢性健康状况的儿童的家庭计划的竞争中，还没有提供和评估过这种治疗方法。计划进行三项研究，以适应和测试一种特定的问题解决干预措施，即问题解决治疗(PST)，以防止子女参加马萨诸塞州EL计划的母亲出现和再次出现抑郁症状。我将使用定性的方法来探索产妇和工作人员对在El解决产妇心理健康问题的看法。第二项研究采用定性和定量的方法，使PST适应EL环境。最后一个项目将是一项准实验研究，其中6名接受过PST培训的El Case工作人员将治疗24个家庭，以测试PST对母亲抑郁症状、研究的主要结果以及母亲的社会功能、育儿压力和母子互动质量的影响。该项目将用于确定设计后续适当的分组随机临床试验所需的方法学参数。我的目标是利用从这些研究中获得的信息来设计并为纵向集群RCT寻求资金，以检验我的假设，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轻高危母亲抑郁症状的负担。

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.