Risk and resilience: Evaluating the multigenerational effect of a psychosocial maternal depression intervention against COVID-19-related stressors

摘要 新冠肺炎是一场全球性的公共健康危机，对生活在 在易受攻击的环境中。新出现的研究表明，封锁造成的经济冲击 政策产生了特别毁灭性的影响，但不太清楚这些有害的影响会持续多久 影响将会是。此外，大流行对产妇心理健康的影响加上情况恶化 经济状况对儿童的心理健康有重大影响，导致多方面的 代际影响。为了减轻几代人对心理健康的破坏性影响， 对于更好地了解感染新城疫风险最高的母亲和儿童的特征至关重要- 并评估预防性干预的潜在缓冲效果。vbl.使用 来自一项正在进行的农村妇女研究的纵向实验和观察数据 巴基斯坦，拟议研究的首要目标是深入了解多代人的 新冠肺炎应激源的心理健康影响，并确定风险和保护因素，包括 心理社会抑郁干预。该研究利用了来自 巴克潘研究，一项由美国国立卫生研究院资助的随机分组纵向队列研究 实施生命过程的心理社会性母亲抑郁干预对照试验 策略(U19MH095687；R01HD075875)。在主要的研究中，女性被招募在他们的 从2015年开始怀孕第三个月，目前正在参与第8波数据 收藏，在儿童6岁时(最终n=&gt；793)。丰富的数据集包括多个属性域的信息 妇女和儿童的社会背景以及高质量的心理健康措施。一本小说 测量家庭暴露于与COVID相关的广泛应激源的COVID模块是 加上6年来的波动。在我们的第一个目标中，我们将研究经济冲击和 大流行头两年对儿童妇幼心理健康的不确定性 6岁，并提供证据表明高度不确定性的环境可能会产生怎样的影响 孕产妇和儿童的心理健康，超过实现的经济减幅 意思是。在第二个目标中，我们将检查是否参加一个心理社会母亲 过去对抑郁症的干预导致对不断恶化的心理健康的韧性增强 在大流行期间。在第三个目标中，使用持续不断的数据收集到8岁儿童，我们将 检查复苏或更长期影响的预测因素。这对公共卫生的主要贡献 该项目将产生关于新冠肺炎应激源如何影响心理轨迹的知识 在资源匮乏的情况下妇女和儿童的健康以及是否存在心理社会抑郁 干预措施为应对大流行期间不断恶化的精神健康提供了韧性。

ABSTRACT COVID-19 is a global public health crisis with disproportionate mental health impacts on populations living in vulnerable contexts. Emerging research suggests that the economic shocks resulting from lock-down policies have had an especially devastating impact, yet it is less clear how long lasting these deleterious impacts will be. Furthermore, the pandemic’s impact on maternal mental health combined with worsening economic conditions have significant consequences for the mental health of children, resulting in multi- generational impacts. In order to mitigate the devastating impact on mental health across generations, it is crucial to better understand the characteristics of mothers and children who were most at risk from COVID- related stressors and to evaluate the potential buffering effects of preventative interventions. Using longitudinal experimental and observational data from an ongoing study of women in rural Pakistan, the overarching goal of the proposed study is to gain insights into the multi-generational mental health impacts of COVID-19 stressors and identify risk and protective factors, including a psychosocial depression intervention. This study leverages existing data and infrastructure from the Bachpan study, an NIH funded longitudinal cohort with an embedded cluster-randomized control trial of a psychosocial maternal depression intervention with a life course implementation strategy (U19MH095687; R01HD075875). In the main study, women were recruited during their third trimester of pregnancy starting in 2015 and are currently participating in the 8th wave of data collection, at child age 6 (final n=>793). The rich dataset includes information on multiple domains of women’s and children’s social context as well as high-quality measures mental health. A novel COVID module measuring household exposure to a broad range of COVID-related stressors was added to the 6-year wave. In our first aim we will examine the role of economic shocks and uncertainty during the first two years of the pandemic on maternal and child mental health at child age 6 years and provide evidence of how an environment of heightened uncertainty might impact both maternal and child mental health, above and beyond the realized reduction in economic means. In the second aim, we will examine whether participating in a psychosocial maternal depression intervention in the past leads to increased resilience against worsening mental health during the pandemic. In the third aim, using ongoing data collection through child age 8, we will examine predictors of recovery or longer impacts. The major public health contribution of this project will be to generate knowledge on how COVID-19 stressors impacted trajectories of mental health for women and children in a low resource context and whether a psychosocial depression intervention provided resilience against worsening mental health during the pandemic.