Social Media, Teen Moms, and PPD

描述（由申请人提供）： 在美国，每年大约有40万例活产发生在青少年身上。在50%经历抑郁症状的青少年母亲中，由于缺乏对抑郁症状的了解，（识字），对心理健康治疗持消极态度，认为抑郁症患者会被污名化（主观规范），缺乏对她可以利用和在她控制下的卫生资源的了解（感知控制），以及缺乏时间。未经治疗的抑郁症在这个弱势群体中造成了公共卫生问题，影响了青少年的关系，工作和学校的运作，寻求医疗保健的行为，母亲的技能，以及她孩子的发展。需要一种创新和基于证据的方法，克服这些障碍，是可行的，是青少年母亲可以接受的，并导致更高的抑郁症治疗率。社交媒体是接触和教育青少年母亲的一个有希望的工具，因为大多数青少年母亲使用社交媒体进行交流和搜索健康信息。根据计划行为理论，我们将针对肯塔基州的10个县开展社交媒体广告活动，这将使这些县的青少年母亲（n=140）参加与产后抑郁症相关的基于互联网的干预活动。先前测试的干预措施包括来自其他青少年母亲的小插曲，问题和答案，资源，以及注册短信服务的选项。在干预前、干预后和两周后，青少年母亲将完成既定的问卷调查，以确定干预是否改善了对抑郁症和抑郁症治疗的态度和主观规范，与寻求抑郁症治疗相关的感知控制和意图，以及接受抑郁症治疗的有抑郁症症状的青少年母亲的数量。数据将与来自对照组（肯塔基州的其他10个县）的青少年母亲（n=140）的相同工具的分数进行比较，这些青少年母亲没有成为社交媒体广告活动的目标或参与干预。将与社区机构合作收集对照组中未成年母亲的数据。本试验的总体目的是测试一种具有成本效益和可行性的方法，用于减少青少年母亲获得抑郁症治疗的认知和情感障碍。具体目标是（1）衡量社交媒体广告活动作为招聘策略的有效程度;（2）测试基于互联网的社会营销干预对寻求治疗的意图和抑郁症治疗率的有效性，以及（3）检查干预的剂量效应。创新性地使用社交媒体广告和基于互联网的社会营销干预来提高青少年母亲的抑郁症治疗率，有可能改善两代人的公共健康，青少年母亲及其婴儿，并使我们能够解决严重的国家健康问题。

DESCRIPTION (provided by applicant): Approximately 400,000 live births occur to adolescents in the United States annually. Of the 50% of adolescent mothers who experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment due to lack of knowledge of depression symptoms (literacy), negative attitude towards mental health treatment, perception that individuals with depression are stigmatized (subjective norms), lack of understanding of health resources that are available to her and under her control (perceived control), and lack of time. Untreated depression creates a public health problem in this vulnerable group impacting the adolescent's relationships, functioning at work and school, health care seeking behaviors, mothering skills, and development as well as the development of her child. An innovative and evidence based approach is needed that overcomes each of these barriers, is feasible, is acceptable to adolescent mothers and leads to greater rates of depression treatment. Social media is a promising vehicle to reach and educate adolescent mothers since most adolescent mothers use social media for communication and to search for health information. Based upon the Theory of Planned Behavior, we will target 10 counties in Kentucky with a social media ad campaign that will result in adolescent mothers (n=140) from those counties enrolling in an internet based intervention related to postpartum depression. The previously tested intervention includes vignettes from other adolescent mothers, questions and answers, resources, and an option to enroll in text message service. Before the intervention, after the intervention, and two weeks later the adolescent mothers will complete established questionnaires to determine if the intervention improved attitude and subjective norms towards depression and depression treatment, perceived control and intention related to seeking depression treatment, and the number of adolescent mothers with symptoms of depression who receive depression treatment. Data will be compared to scores on the same instruments from adolescent mothers (n=140) from the control group (10 other counties in Kentucky) that have not been targeted with the social media ad campaign or participated in the intervention. Data from the adolescent mothers in the control group will be collected in partnership with community agencies. The overall purpose of this trial is to test a cost effective and feasible method for reducing the cognitive an emotional barriers to accessing depression treatment in adolescent mothers. The specific aims are to (1) measure the extent to which a social media ad campaign is effective as a recruitment strategy; (2) test the effectiveness of an internet based social marketing intervention on both intention to seek treatment and rates of depression treatment, and (3) examine the dose effect of the intervention. The innovative use of social media ads and an internet based social marketing intervention to increase rates of depression treatment in adolescent mothers has the potential to improve public health of two generations, adolescent mothers and their infants, and allows us to address a serious national health problem.