Preventing postpartum depression among immigrant Latinas through a virtual group intervention

项目总结 产后抑郁症(PPD)影响了10%-20%的女性，其中拉丁裔移民受到的影响不成比例。 由于一系列的结构和文化因素，PPD的预防和治疗在拉丁裔移民中有限 因素，表明需要在传统医疗保健环境之外提供干预措施。虚拟 干预措施有可能减少拉丁裔移民获得心理健康服务的障碍，但 关于虚拟干预措施减轻产后抑郁症状的有效性的研究很少。母亲和婴儿是一种 基于认知行为疗法和依恋理论的循证团体干预 旨在预防产后抑郁。母亲和婴儿被改编为通过虚拟团体形式(母亲)分娩 和婴儿虚拟小组；MB-VG)，试点研究表明良好的可行性和可接受性以及 改善拉丁裔移民的心理健康状况。拟议的项目是第一类有效性- 在孕妇和有产后抑郁风险的新母亲中实施随机对照试验 关于在儿童早期登记的抑郁症状和/或其他已确定的危险因素 马里兰州的项目。共有300名妇女参加；150人将接受MB-VG，150人将接受MB-VG 接受通常的家庭支持服务。该项目旨在评估：1)MB-VG减少 抑郁症状，预防产后抑郁发作，提高育儿自我效能感和反应性； 实施MB-VG；以及3)影响MB-VG有效性和实施的背景因素。一个 探索性目标还将检查参与者中的儿童自我调节和入学准备结果 (~N=150)，有2.5-4.5岁的大孩子。训练有素的幼儿中心工作人员将提供MB-VG 会议，干预参与者使用任何电子设备通过Zoom接收虚拟小组会话 (智能手机、平板电脑、笔记本电脑)。母亲的自我报告调查在基线、1周、3个月和6个月进行 干预后几个月，在干预后3个月和6个月进行结构化临床访谈。 干预。与MB-VG促进者和接受者以及幼儿的主要线人面谈 计划总监将提供有关MB-VG实施和影响环境因素的数据 实施。MB-VG交付的保真度将通过干预会议音频的严格编码进行评估 录音。我们的研究是第一次向拉丁裔移民提供虚拟的产后抑郁预防干预，并 评估其影响。鉴于其虚拟交付模式，MB-VG可以轻松复制和扩展到其他 为拉丁裔移民服务的家庭支持计划和环境。如果有效并广泛实施， 拉丁裔移民将接受心理健康服务，更少的人将遭受负面后果 与产后抑郁相关。拟议的项目与NIMHD的高度优先领域保持一致，包括开发 并测试旨在缩小差距的干预措施。

PROJECT SUMMARY Postpartum depression (PPD) affects 10-20% of women, with immigrant Latinas disproportionately affected. PPD prevention and treatment is limited among immigrant Latinas due to an array of structural and cultural factors, suggesting the need to deliver interventions outside of traditional healthcare settings. Virtual interventions have the potential to reduce barriers to mental health services for immigrant Latinas, but there is little research on the effectiveness of virtual interventions to reduce PPD symptoms. Mothers and Babies is an evidence-based group intervention based on principles of cognitive-behavioral therapy and attachment theory aimed at PPD prevention. Mothers and Babies was adapted for delivery via a virtual group format (Mothers and Babies Virtual Group; MB-VG), with a pilot study suggesting good feasibility and acceptability as well as improved mental health outcomes for immigrant Latinas. The proposed project is a Type 1 Effectiveness- Implementation randomized controlled trial among pregnant individuals and new mothers at risk for PPD based on elevated depressive symptoms and/or other established risk factors who are enrolled in early childhood programs across Maryland. A total of 300 women will be enrolled; 150 will receive MB-VG while 150 will receive usual family support services. The project aims to evaluate: 1) the effectiveness of MB-VG to reduce depressive symptoms, prevent onset of PPD, and improve parenting self-efficacy and responsiveness; 2) implementation of MB-VG; and 3) contextual factors influencing MB-VG effectiveness and implementation. An exploratory aim will also examine child self-regulation and school readiness outcomes among participants (~N=150) who have older children aged 2.5-4.5 years. Trained early childhood center staff will deliver MB-VG sessions, with intervention participants receiving virtual group sessions via Zoom using any electronic device (smartphone, tablet, laptop). Maternal self-report surveys are conducted at baseline, 1 week, 3 months, and 6 months post-intervention, with structured clinical interviews also conducted at 3- and 6-months post- intervention. Key informant interviews with MB-VG facilitators and recipients, as well as early childhood program directors will provide data on MB-VG implementation and contextual factors influencing implementation. Fidelity of MB-VG delivery will be assessed via rigorous coding of intervention session audio recordings. Our study is the first to deliver a virtual PPD preventive intervention to immigrant Latinas and to evaluate its impact. Given its virtual delivery modality, MB-VG can be easily replicated and scaled to other family support programs and settings serving immigrant Latinas. If effective and implemented broadly, more immigrant Latinas will receive mental health services and fewer will suffer the negative consequences associated with PPD. The proposed project is aligned with NIMHD’s high priority areas, including developing and testing interventions to reduce disparities.