Social Media-Based Parenting Program for Women with Postpartum Depressive Symptoms

项目总结/摘要 产后抑郁症（PPD）症状在分娩后的妇女中很常见， 会对母亲照顾孩子的能力产生不利影响。因此，患有PPD症状的母亲的婴儿 可能会经历较少的回应养育，使他们在发育延迟的风险更大。证据- 已经制定了基于父母的计划来指导母亲照顾婴儿，但可能不会 解决抑郁症对养育子女的影响，是密集和昂贵的管理能力有限， 扩大或不以便于有抑郁症状的妇女参与的形式提供。 因此，这些妇女可能无法利用育儿计划的好处。我们长久以来- 长期目标是制定有效的育儿策略，以促进母亲的最佳儿童发展 患有产后抑郁症我们申请的总体目标是研究这个项目是否 结合在线抑郁症治疗导致更积极的父母（目标）和信号改善 与抑郁症治疗相比，儿童语言、社会情感和认知发展（结果） 一个人具体目标是：1）确定基于社交媒体的育儿计划是否可以改善 在有PPD症状的母亲中进行响应式育儿（目标），2）以确定社交媒体是否- 基于父母的计划可以提高响应式父母（目标），并标志着更大的儿童发展 （结果）与PPD症状的母亲，和3）探索中介和调解人的影响， 关于回应式育儿的育儿计划拟议的研究将在3-4个初级保健实践中进行 附属于一家大型城市儿童医院，包括2个阶段：最初的试点RCT测试参与 响应式育儿计划（R61）和随后的RCT进一步测试了 该计划和探索儿童发展和调解人和调解人的治疗效果（R33）。在 第一阶段，75名不同种族和民族的妇女，她们的PPD症状筛查呈阳性，并有婴儿 <6个月大的儿童将随机接受育儿计划加在线抑郁症治疗， 在线抑郁症治疗单独评估目标参与。在第二阶段，另有75名符合条件的 妇女将被随机分配接受育儿计划加在线抑郁治疗或抑郁症 单独治疗。在后一阶段，我们将进一步确定育儿计划是否有效 参与拟议的目标，响应父母，并标志着更大的儿童发展状况比 在线抑郁症治疗计划。此外，我们还将探讨治疗的中介者和调节者 对响应式育儿的影响。这一应用的结果预计将有助于重要的新的 了解并告知未来的育儿策略试验，以更好地帮助患有PPD症状的母亲， 改善儿童发展成果。

Project Summary/Abstract Postpartum depressive (PPD) symptoms are common among women following the birth of a child and can adversely impact a mother's ability to care for her child. As a result, infants of mothers with PPD symptoms may experience less responsive parenting, placing them at greater risk for delays in development. Evidence- based parenting programs have been developed to guide mothers with caring for their infants but may not address the impact of depression on parenting, are intensive and expensive to administer with limited ability for scale up, or are not available in a format that facilitates participation by women with depressive symptoms. Therefore, these women may not be able to take advantage of the benefits of parenting programs. Our long- term goal is to develop effective parenting strategies to facilitate optimal child development for mothers suffering with PPD symptoms. Our overall objective for this application is to study whether this program combined with online depression treatment leads to more responsive parenting (target) and signals improved child language, socioemotional and cognitive development (outcomes) compared to depression treatment alone. The specific aims are 1) to determine whether a social media-based parenting program can improve responsive parenting (target) among mothers with PPD symptoms, 2) to determine whether a social media- based parenting program can improve responsive parenting (target) and signal greater child development (outcome) among mothers with PPD symptoms, and 3) to explore mediators and moderators of the effects of the parenting program on responsive parenting. The proposed study will occur at 3-4 primary care practices affiliated with a large urban children's hospital and consist of 2 phases: an initial pilot RCT testing engagement of the parenting program on responsive parenting (R61) and a subsequent RCT further testing engagement of the program and exploring child development and mediators and moderators of treatment effect (R33). In the first phase, 75 ethnically and racially diverse women who screen positive for PPD symptoms and have infants <6 months of age will be randomized to receive the parenting program plus online depression treatment or online depression treatment alone to assess target engagement. In the second phase, an additional 75 eligible women will be randomized to receive the parenting program plus online depression treatment or depression treatment alone. In this latter phase, we will further determine whether the parenting program effectively engages the proposed target, responsive parenting, and signals greater child developmental status than the online depression treatment program. In addition, we will explore mediators and moderators of treatment effects on responsive parenting. The results of this application would be expected to contribute important new knowledge and inform a future trial on parenting strategies to better assist mothers with PPD symptoms and improve child developmental outcomes.