Maternal Depression and Early Head Start

描述（由候选人提供）：母亲抑郁症是母亲和儿童大量发病的来源。这个K23应用程序概述了一个指导的5年教育和研究计划，致力于开发和研究早期开端（EHS）中的母亲抑郁症自我管理支持系统，这是一个联邦资助的低收入家庭早期儿童发展计划。基于慢性护理模式的干预措施将涉及通过标准化工具识别有抑郁症状的母亲，以及涉及动机增强和解决问题治疗的病例管理系统。通过这些策略，后者是一种基于证据的抑郁症治疗方法，EHS个案工作者将把母亲与进一步的基于证据的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。与EHS母亲进行定性访谈，以确定将自己的心理健康作为子女学前教育经验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，了解参与此类个案管理系统的个人和机构障碍; 3.通过为期9个月的试点干预，制定病例管理规程的细节; 4.进行一项准实验研究的系统，以测试其对EHS母亲的抑郁症，抑郁症状，社会功能，质量的母亲教学互动与他们的孩子，和儿童保健利用服务的接收效果。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以及亲子互动分析的经验。从这个项目中获得的信息和经验将被用来设计一个纵向随机对照试验，研究这个系统对母亲的抑郁症状和他们的孩子的发育结果的影响。

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.