Evaluation and validation of a novel instrument to assess the psychosocial and drug history backgrounds of pregnant women with or without Opioid Use Disorder

评估和验证一种新工具，用于评估患有或不患有阿片类药物使用障碍的孕妇的社会心理和药物史背景

• 批准号: 10382639
• 负责人: Heidi Preis
• 金额: $ 43.24万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10382639
• 关键词: Affect; Allium schoenoprasum; Anxiety; Behavior; Biometry; Birth; COVID-19; COVID-19 pandemic; Clinical Psychology; Cohort Studies; Color; Common Data Element; Contracts; Data; Data Set; Discipline of obstetrics; Discrimination; Disease Outbreaks; Economics; Emergency Situation; Environmental Risk Factor; Epidemiology; Ethnic Origin; Evaluation; Event; Foundations; Funding; Future; Gender; Gender Identity; Geography; Gynecology; Health; Health Psychology; Health behavior; Healthcare; Individual; Infection; Interdisciplinary Study; Intervention; Investigation; Life; Long-Term Effects; Low Birth Weight Infant; Maternal Health; Measures; Mediating; Mental Depression; Mental Health; Morbidity - disease rate; Obsessive compulsive behavior; Outcome; Participant; Pathway interactions; Persons; Pharmaceutical Preparations; Postpartum Period; Pregnancy; Pregnant Women; Premature Birth; Prenatal care; Prevention; Psyche structure; Psychological Factors; Psychosocial Factor; Public Health; Race; Recording of previous events; Reporting; Request for Applications; Risk Factors; Role; Seeds; Social Psychology; Social Work; Social isolation; Socioeconomic Status; Stress; Structural Racism; Surveys; Symptoms; Time; Uncertainty; United States National Institutes of Health; Universities; Validation; World Health Organization; anxiety symptoms; behavioral health; child bearing; clinically significant; cohort; drug abuse in pregnancy; early experience; experience; generalized anxiety; hazard; health care availability; health care quality; health inequalities; instrument; maternal morbidity; maternal outcome; maternal risk; maternal stress; novel; opioid use disorder; pandemic disease; perceived stress; perinatal outcomes; physical conditioning; pregnant; prenatal; prospective; psychosocial; racial and ethnic; racism; recruit; sexual identity; social factors; social health determinants; socioeconomics

Abstract The COVID-19 pandemic provides an unprecedented opportunity to conduct prospective, longitudinal investigation of the effects of Social Determinants of Health (SDoH), including Structural Racism and Discrimination (SRD), and maternal stress on maternal physical and mental health morbidity. The Stony Brook COVID-19 Pregnancy Experiences (SB-COPE) Study, which forms the foundation for the proposed project, includes detailed prospective psychosocial data from over 7,400 persons who were pregnant at the beginning of the COVID-19 pandemic (n=4,400) or at the second U.S. COVID-19 surge (n=3,000), including 1,400 persons of color. The main objectives of this Urgent Competitive Revision proposal are to prospectively determine pandemic-related impacts on maternal stress, identify SDoH mechanisms associated with these impacts, and investigate the effects of stress on maternal morbidity and perinatal outcomes. The proposal seeks to extend assessment of the SB-COPE Study cohort for an additional year, and to follow participants into the first year postpartum, including, for some, into their next pregnancy. The proposed project will: Aim 1) Identify contributors to maternal stress during the pandemic. It is hypothesized that pregnant persons affected by SDoH, including SRD, will experience more stress as a result of the pandemic. SDoH to be investigated in the pandemic context include geographical disparities, race/ethnicity, relationship and economic status, and sexual and gender identity. SRD factors include prenatal gendered racism, everyday discrimination, and discrimination in healthcare. Stress factors include global perceived stress, pandemic- related stress, pregnancy-specific stress, and stressful life events. Aim 2) Identify contributors to prenatal and postpartum mental health morbidities during the pandemic. Persons with higher levels of stress are hypothesized to report greater mental health morbidities (depression, anxiety, and obsessive-compulsive symptoms) prenatally and in the postpartum period. Differential effects of stress types (e.g., pandemic-related stress, stressful life events) and interactions among stress, SDoH, and SRD (including healthcare access and quality) in predicting mental health outcomes will be examined. Aim 3) Identify pathways resulting in poorer maternal physical health and adverse perinatal outcomes during the pandemic. It is hypothesized that SDoH will predict greater likelihood of adverse perinatal outcomes (e.g., low birthweight, preterm birth; emergency delivery). This association is predicted to be mediated by prenatal maternal stress, maternal health behaviors, and healthcare access and quality. This critically timed project capitalizes on an existing, extensive baseline dataset (including NIH common data elements), large SB-COPE Study cohorts pregnant during critical pandemic periods, including a sizeable number of persons of color, and the highly relevant expertise of a multidisciplinary research team to rigorously identify SDoH, SRD, and explain their stress-related effects on pregnant persons in the context of the COVID-19 pandemic.

抽象的 COVID-19 大流行为开展前瞻性、纵向研究提供了前所未有的机会 调查健康的社会决定因素（SDoH）的影响，包括结构性种族主义和 歧视（SRD）和孕产妇压力对孕产妇身心健康发病率的影响。石溪 COVID-19 怀孕经历 (SB-COPE) 研究构成了拟议项目的基础， 包括超过 7,400 名怀孕初期的人的详细前瞻性社会心理数据 COVID-19 大流行期间 (n=4,400) 或美国第二次 COVID-19 激增时 (n=3,000)，其中包括 1,400 人 有色人种。该紧急竞争性修订提案的主要目标是前瞻性地 确定大流行病对孕产妇压力的相关影响，确定与这些相关的 SDoH 机制 影响，并调查压力对孕产妇发病率和围产期结局的影响。提案 寻求将 SB-COPE 研究队列的评估再延长一年，并对参与者进行跟踪 到产后第一年，包括对某些人来说到下一次怀孕。拟议项目将： 目标 1) 确定大流行期间造成产妇压力的因素。据推测，怀孕的人 受 SDoH 影响，包括 SRD，将因疫情而承受更大的压力。 SDoH 是 在大流行背景下进行的调查包括地理差异、种族/族裔、关系和经济 地位以及性和性别认同。 SRD 因素包括产前性别种族主义、日常生活 歧视，以及医疗保健方面的歧视。压力因素包括全球感知压力、流行病- 相关压力、怀孕特定压力和压力生活事件。目标 2) 确定产前的贡献者 以及大流行期间的产后心理健康疾病。压力水平较高的人是 假设报告更多的心理健康疾病（抑郁、焦虑和强迫症） 症状）产前和产后期。压力类型的不同影响（例如，与流行病相关的压力） 压力、压力生活事件）以及压力、SDoH 和 SRD 之间的相互作用（包括医疗保健获取和 将检查预测心理健康结果的质量）。目标 3) 找出导致贫困的途径 大流行期间孕产妇身体健康和不良围产期结局。假设 SDoH 将预测不良围产期结局的可能性更大（例如，低出生体重、早产； 紧急送货）。预计这种关联是由产前母亲压力、母亲健康介导的 行为、医疗保健的获取和质量。这个时间紧迫的项目利用了现有的、广泛的 基线数据集（包括 NIH 通用数据元素），大型 SB-COPE 研究队列怀孕期间 关键的大流行时期，包括大量有色人种，以及高度相关的专业知识 多学科研究团队严格识别 SDoH、SRD，并解释它们与压力相关的影响 COVID-19 大流行背景下的孕妇。

项目成果

Saving time, signaling trust: Using the PROMOTE self-report screening instrument to enhance prenatal care quality and therapeutic relationships.

节省时间，传递信任：使用 PROMOTE 自我报告筛查工具提高产前护理质量和治疗关系。

• 发表时间: 2022-12
• 作者: Preis, Heidi;Whitney, Clare;Kocis, Christina;Lobel, Marci
• 通讯作者: Lobel, Marci

Missingness patterns in a comprehensive instrument identifying psychosocial and substance use risk in antenatal care.

识别产前护理中心理社会和药物使用风险的综合工具中的缺失模式。

• 发表时间: 2023-09
• 影响因子: 2.5
• 作者: Preis, Heidi;Djurić, Petar M;Ajirak, Marzieh;Mane, Vibha;Garry, David J;Garretto, Diana;Herrera, Kimberly;Heiselman, Cassandra;Marci, Lobel
• 通讯作者: Marci, Lobel

Common model of stress, anxiety, and depressive symptoms in pregnant women from seven high-income Western countries at the COVID-19 pandemic onset.

COVID-19 大流行爆发时七个西方高收入国家孕妇的压力、焦虑和抑郁症状的常见模式。

• 发表时间: 2022-12
• 作者: Lobel, Marci;Preis, Heidi;Mahaffey, Brittain;Schaal, Nora K;Yirmiya, Karen;Atzil, Shir;Reuveni, Inbal;Balestrieri, Matteo;Penengo, Chiara;Colli, Chiara;Garzitto, Marco;Driul, Lorenza;Ilska, Michalina;Brandt;Kołodziej
• 通讯作者: Kołodziej