African-American Social Support Effectiveness Treatment- Partners Alleviating Perinatal Depression (ASSET-PPD)

项目摘要/摘要 这一探索性/发展性研究资助计划(R21)解决了非洲- 美国(AA)女性。再生障碍性贫血母亲患围产期抑郁症的风险比高加索妇女更高，即 这是由于社会环境压力增加所致。再生障碍性贫血妇女的医疗保健利用率很低， 与高加索妇女相比，对精神治疗的依从性。需要进行干预，以 补充和支持母亲抑郁症护理的临床目标，而不需要母亲的 直接牵涉其中。父亲是一种未得到充分利用的资源，可以减轻母亲的环境压力， 鼓励健康的母性行为。PI将测试非裔美国人的社会支持有效性 治疗-合作伙伴缓解围产期抑郁(ASSET-PPD)方案，作为对 孕产妇围产期精神治疗。Asset-PPD将针对父亲对母亲精神上的支持 保健治疗和她们积极参与家庭生活，以减轻母亲的压力。 ASSET-PPD干预将设计为有4个主动模块，以解决关键因素以减少 产前和产后两次回顾会议期间的母体应激。ASSET-PPD设计为 单独的会话。干预是基于压力产生和认知模型的理论模型。 行为理论。这些模块将是单独的课程，旨在提供培训、信息和 增加父亲的行为分配：1)产前和产后家庭参与；2)心理健康 心理教育；3)父母之间的沟通和关系技巧；以及4)平衡的家庭分裂 任务。一个由父母组成的干预后重点小组将向PI通报 干预行动。此外，一个专题专家小组将成为外部咨询委员会的一部分，以 就干预措施的发展提供反馈。手册的最终定稿将根据以下条件执行 干预的表现，以及焦点小组和咨询委员会的反馈。 ASSET-PPD将在一项试点RCT中进行评估，50名同居父亲和AA母亲将 随机分为ASSET-PPD干预组或对照组。只有父亲才会参加 通过干预，母亲和父亲将完成心理健康和父母经历的测量。 母亲的抑郁症状将被评估为主要结果，母乳喂养和亲子 相互作用将被评估为次要结果，以告知选定的衡量标准在未来的效用 大规模随机对照试验。该方案的目的是：1)评估干预措施对夫妇的可接受性； 2)确定招聘率；3)评估每个模块关键组件的效用；4)评估 每项措施是否足以评估干预措施所针对的结果；以及5)确定 试点数据证明有必要进行大规模随机对照试验。

Project Summary/Abstract This Exploratory/Developmental Research Grant Program (R21) addresses perinatal depression in African- American (AA) women. AA mothers have a higher risk for perinatal depression than Caucasian women that is attributable to increased socio-environmental stressors. AA women have poor healthcare utilization and compliance with psychiatric treatment compared to Caucasian women. An intervention is required to supplement and support the clinical objectives of the mother’s depression care without requiring the mother’s direct involvement. Fathers are an underutilized resource to reduce the mother’s environmental stress and encourage healthy maternal behaviors. The PI will test the African-American Social Support Effectiveness Treatment- Partners alleviating Perinatal Depression (ASSET-PPD) protocol, a supplemental intervention to maternal perinatal psychiatric treatment. ASSET-PPD will target the fathers’ support of the mothers’ mental health treatment and their active engagement in the family to reduce maternal stress. The ASSET-PPD intervention will be designed to have 4 active modules that address key factors to reduce maternal stress during the prenatal period and 2 postpartum review sessions. ASSET-PPD is designed as individual sessions. The intervention is based on the theoretical models of the stress-generation and cognitive- behavior theories. The modules will be individual sessions constructed to provide training, information, and behavioral assignments to increase fathers’: 1) prenatal and postpartum family involvement; 2) mental health psychoeducation; 3) interparental communication and relationship skills; and 4) balanced division of family tasks. A post-intervention focus group of mothers and fathers will inform the PI of the utility and acceptability of the intervention. In addition, a panel of subject matter experts will be part of an external advisory board to provide feedback on the intervention development. The finalization of the manual will be executed based on the intervention’s performance, and the focus groups’ and advisory board’s feedback. ASSET-PPD will be evaluated in a pilot RCT with 50 cohabitating fathers and AA mothers who will be randomized into the ASSET-PPD intervention or the comparator group. Fathers only will participate in the intervention, and mothers and fathers will complete measures of mental health and parental experiences. Maternal depressive symptoms will be assessed as a primary outcome, and breastfeeding and parent-infant interactions will be assessed as secondary outcomes to inform the utility of the selected measures for a future large-scale RCT. The objective of this protocol is to: 1) assess the acceptability of the intervention to couples; 2) determine the recruitment rate; 3) evaluate the utility of each module’s key components; 4) assess the adequacy of each measure to evaluate the outcomes targeted by the interventions; and 5) determine whether the pilot data warrant a large-scale RCT.