Evaluating perinatal mood and anxiety disorder in Kenyan: a mixed methods approach

评估肯尼亚围产期情绪和焦虑症：混合方法

基本信息

批准号：
10462206
负责人：
Anna M Larsen
金额：
$ 7.13万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10462206
关键词：
Affect Africa South of the Sahara African Age Anxiety Anxiety Disorders Area Behavior Characteristics Child Child Health Clinic Cohort Studies Data Development Developmental Delay Disorders Disease Management Disease remission Economics Education Emotional Enrollment Epidemiology Equation Event Future Generalized Anxiety Disorder Health Infant Infant Behavior Influentials Interruption Intervention Interview Link Longevity Maternal Age Maternal and Child Health Measures Mental Depression Mental Health Mental Health Services Methods Mood Disorders Mothers Outcome Participant Pathological anxiety Pathway interactions Patient Preferences Patients Perinatal Play Population Positioning Attribute Postpartum Period Postpartum Women Pregnancy Pregnant Women Qualitative Methods Reading Reporting Research Research Personnel Research Project Grants Risk Risk Estimate Site Social support Socioeconomic Status Specific qualifier value Stress Surveys Time UNICEF Visit Woman anxiety symptoms center for epidemiological studies depression scale cohort critical period depressive symptoms dyadic interaction early childhood evidence base experience health of the mother high risk improved infant outcome intimate partner violence modifiable behavior novel parity patient oriented perceived stress perinatal outcomes perinatal period peripartum depression post-doctoral training preference prospective psychologic response social social skills therapy design therapy development uptake

项目摘要

ABSTRACT This F32 project aims to advance understanding of perinatal mood and anxiety disorders (PMAD), their consequences to infant social-emotional development, modifiable behaviors to alleviate PMAD, and preferences for evidence-based PMAD management approaches. Approximately 20% of women worldwide report PMAD during pregnancy or within the first year postpartum—predominantly depression, anxiety, and high stress. Maternal PMAD increases risk of adverse infant outcomes. Risk of social-emotional developmental (SED) delays is 60% higher among infants born to women experiencing PMAD compared to infants unexposed to PMAD. Infant SED impacts mental health, social competence, and economic attainment throughout the lifespan. Little is known about particularly influential timing of PMAD within the perinatal period which could optimize intervention timing for maximal benefit to mother-infant dyads. Maternal engagement with infants through interactive behaviors like playing, talking, and singing may mitigate mechanisms connecting PMAD and infant SED delays. Low quality dyadic interactions are more likely with maternal PMAD and associated with suboptimal SED. Interventions that increase mother-infant engagement quality improve infant SED, yet improvement to maternal mental health is unclear. Gaps remain in understanding preferences for PMAD interventions among pregnant and postpartum women in the sub-Saharan African region where PMAD disproportionately affects women and maternal child health (MCH) clinics are widely attended, offering a high-impact access point for maternal mental health services. The proposed F32 research project leverages data from an ongoing cohort study (PrIMA-X, R01HD100201, PI: Pintye) among 1300 Kenyan mother-infant pairs followed from pregnancy through 36-months postpartum with longitudinal assessment of maternal perinatal mood and anxiety disorder, mother-infant engagement, and infant-child social-emotional development. In Aim 1, we will use dyadic data collected monthly in pregnancy and 6-monthly through 36 months postpartum to prospectively assess impact and timing of PMAD on SED delays among Kenyan mother-infant pairs. In Aim 2, we will determine the relationship between mother-infant engagement and PMAD remission timing longitudinally through 36 months postpartum, potentially highlighting an effective avenue for intervention. In Aim 3, we will evaluate acceptability and preferences for PMAD management approaches among perinatal Kenyan women to inform patient-driven intervention design using qualitative methods guided by the Theoretical Framework of Acceptability. This large- scale mixed method study will contribute novel data toward informing a future PMAD intervention. The research plan will provide the F32 candidate rigorous postdoctoral training including: 1) advanced epidemiologic and time- to-event methods using longitudinal data with repeated measures, 2) experience with qualitative methods to inform a patient-centered intervention, 3) content-area expertise in maternal-infant mental health—an area critical to closing MCH gaps.

抽象的这个F32项目旨在提高人们对围产期情绪和焦虑症的了解（PMAD）对婴儿社会情感发展的后果，减轻PMAD的可修改行为和偏好用于基于证据的PMAD管理方法。大约20％的全球妇女报告PMAD 在怀孕期间或产后第一年之内 - 抑郁症，焦虑和高压力。产妇PMAD增加了不良婴儿预后的风险。社会情感发展（SED）延迟的风险与PMAD出乎意料的婴儿相比，经历PMAD的女性出生的婴儿的婴儿高出60％。婴儿SED会影响整个生命周期的心理健康，社会能力和经济成就。小的知道在围产期内PMAD的特别有影响力的时机已知，这可以优化干预时机为母子二元组提供最大收益。通过互动行为，例如演奏，说话和唱歌，可能会减轻连接PMAD和婴儿的机制 SED延迟。低质量的二元相互作用与母体PMAD更有可能，并且与次优相关 sed。提高母亲参与质量改善婴儿的干预措施，但改进孕产妇的心理健康尚不清楚。差距仍然是理解PMAD干预措施的偏好 PMAD不成比例地影响的撒哈拉以南非洲地区的孕妇和产后妇女妇女和产妇儿童健康（MCH）诊所被广泛参加，为孕产妇心理健康服务。拟议的F32研究项目利用正在进行的队列中的数据研究（Prima-X，R01HD100201，PI：PINTYE）在1300肯尼亚的母亲伴对中，随后是怀孕通过36个月的产后，对母亲围产期情绪和焦虑症的纵向评估，母子的敬业度和婴儿社会情感发展。在AIM 1中，我们将使用二元数据每月在怀孕和6个月至6个月的产后收集，以评估影响以及肯尼亚母亲对的SED延迟时间的PMAD时机。在AIM 2中，我们将确定母亲订婚与PMAD缓解时间之间的关系纵向到36个月产后，有可能强调有效的干预途径。在AIM 3中，我们将评估可接受性肯尼亚妇女中PMAD管理方法的偏好，以告知患者驱动干预设计采用可接受性理论框架指导的定性方法。这个很大的比例混合方法研究将为未来的PMAD干预提供新的数据。研究计划将为F32候选人提供严格的博士后培训，包括：1）高级流行病学和时间 - 使用重复度量的纵向数据，2）具有定性方法的经验告知以患者为中心的干预措施，3）孕产妇心理健康方面的内容区域专业知识对于缩小MCH间隙至关重要。