Group-based Prevention of Postpartum Depression: In-person vs. Virtual Delivery

项目摘要 抑郁症是最常见的围产期并发症之一，七分之一的母亲有资格被诊断为抑郁症。 产后抑郁症（PPD），甚至更高的利率为那些谁确定为西班牙裔/拉丁美洲，黑人或非洲人 美国人、美洲印第安人或阿拉斯加原住民，或多个种族或民族。该项目解决了这一问题 预防产后抑郁症的服务存在重大差距，特别是在社会经济弱势群体和少数群体中 组它测试了英语和西班牙语的虚拟围产期预防干预措施的好处， 可扩展性，并满足服务不足人群的心理健康需求。该项目将测试虚拟 在一个随机化的研究中， 对照试验（RCT）。与RFA-MH-21-240的第三优先级一致，本有效性试验将提供 对预防性干预措施的测试，具有强大的证据基础，可扩展，可忠实地提供 在产科护理的环境中，服务提供者。在这个项目中，孕妇将 随机接受基于证据的团体预防计划（伸出援手，保持坚强， 新妈妈; ROSE）为围产期人群设计，a）亲自在医院分娩， 或B）实际上由同一工作人员通过视频会议提供产前护理， 英语和西班牙语。本项目将测试以下几个方面的目标：1：测试虚拟群体预防的有效性 与亲自分娩相比，干预计划对减少产后抑郁症的影响。2：确定机制 改变的干预和特征，预测谁获得最大的好处。3：提供 在其他妇女保健中实施和维持方案的建议 设置.该项目产生的发现将建立一个预防性干预模式， 在不同的医疗保健和社区环境中大规模实施，作为一种低成本，高覆盖率的手段， 预防产后抑郁症。

PROJECT SUMMARY Depression is one of the most common perinatal complications, with 1 in 7 mothers qualifying for a diagnosis of postpartum depression (PPD) and even higher rates for those who identify as Hispanic/Latine, Black or African American, American Indian, or Alaska Native, or by multiple races or ethnicities. This project addresses this major gap in services to prevent PPD, particularly among socioeconomically disadvantaged and minoritized groups. It tests the benefit of a virtual perinatal preventive intervention in English and Spanish to increase access, scalability and address the mental health needs of underserved populations. This project will test the virtual verison against the in-person version of a service-ready efficacious preventive intervention in a randomized controlled trial (RCT). Consistent with the third priority from RFA-MH-21-240, this effectiveness trial will provide a test of a preventive intervention with a strong evidence base that is scalable and can be delivered with fidelity by service providers in settings where obstetric care is received. In this project, pregnant women will be randomized to receive an evidence-based group prevention program (Reach Out, Stay Strong, Essentials for New Moms; ROSE) designed for perinatal populations either a) in person, delivered at the hospital where they are receiving prenatal care or b) virtually, delivered by the same staff via video conferencing, both offered in English and Spanish. This project will test the following aims: 1: Test effectiveness of a virtual group preventive intervention program on reducing postpartum depression compared to in-person delivery. 2: Identify mechanisms of change for the intervention and characteristics that predict who receives the greatest benefit. 3: Provide implementation recommendations for transporting and sustaining programs in other women’s healthcare settings. The discoveries generated by this project will establish a preventive intervention model that can be implemented at scale in diverse healthcare and community settings as a low-cost, high reach means of preventing postpartum depression.