Impact of a Cognitive Behavioral Stress Management Intervention on Cortisol Regul

认知行为压力管理干预对皮质醇调节的影响

• 批准号: 8142861
• 负责人: Guido G. Urizar
• 金额: $ 12.1万
• 依托单位: CALIFORNIA STATE UNIVERSITY LONG BEACH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8142861
• 关键词: Adopted; Adverse effects; Affect; American; American College of Obstetricians and Gynecologists; Applications Grants; Attention; Behavior; Behavioral; Biological; Birth; Caring; Cognitive; Consultations; Data; Development; Doctor of Philosophy; Educational workshop; Funding; Future; Goals; Grant; Health; Health Psychology; Hormones; Hydrocortisone; Immune; Individual; Infant; Infant Health; Intervention; Knowledge; Lead; Life; Low income; Maternal Health; Maternal and Child Health; Mediating; Mediator of activation protein; Mentors; Mentorship; Methodology; Methods; Mothers; Neurosecretory Systems; Outcome; Output; Physiological; Population; Postnatal Care; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prenatal care; Principal Investigator; Process; Psychology; Psychoneuroendocrinology; Public Health; Randomized; Randomized Controlled Trials; Relative (related person); Relaxation; Research; Research Personnel; Risk; Scientist; Self Efficacy; Stress; Subgroup; Testing; Training; Training Programs; Woman; Work; arm; base; behavior change; career; community setting; comparison group; coping; cost; efficacy testing; experience; innovation; intervention effect; meetings; preference; prenatal; prenatal stress; prevent; professor; programs; public health relevance; secondary outcome; skills; skills training; stress management; stress related disorder; symposium; therapy design; working group

DESCRIPTION (provided by applicant): As demonstrated by a growing number of studies, stress experienced during pregnancy can lead to significant long-term health problems for mothers and their infants. One biological mechanism that has been identified in heightening a woman's risk for developing stress-related health complications during pregnancy and the postpartum period is the stress hormone cortisol. However, the best methods for regulating cortisol, in order to optimize maternal and infant health outcomes, have received little attention. The objective of the proposed research is to conduct a two- arm; pilot randomized controlled study to test the efficacy of a prenatal cognitive behavioral stress management (CBSM) intervention in regulating cortisol and stress levels among low-income pregnant women. A total of 100 women will be randomized to either a group-based, 8-week prenatal CBSM arm (i.e., cognitive coping and relaxation skills training) or a standard-of-care comparison arm (i.e., usual pre- and postnatal care) to examine whether women receiving the CBSM intervention will have significantly lower cortisol output and stress levels, relative to women randomized to the standard-of-care comparison arm. This study will also examine whether these decreases in cortisol and stress levels are mediated through behavior change processes (e.g., increased self- efficacy and use of cognitive coping and relaxation skills). This hypothesis has been formulated on the basis of preliminary data collected by the principal investigator and study collaborators. Through formative research, this pilot work will develop and empirically test a prenatal CBSM stress management intervention among low-income pregnant women for use in local prenatal centers. The results of the proposed work have substantial public health implications and are expected to advance our understanding of how pregnant women effectively use these cognitive coping and relaxation skills to adopt healthy behaviors and produce change that can positively impact their health, as well as that of their infant. Further, the proposed research will yield a CBSM intervention that can be readily delivered in community settings, is scalable, and is relatively low cost. Finally, these results will help identify those subgroups of pregnant women that may do particularly well (or poorly) with these innovative approaches to stress management. This has important implications for the tailoring of CBSM programs to individual needs and preferences. PUBLIC HEALTH RELEVANCE: As demonstrated by a growing number of studies, experiencing high levels of stress during pregnancy, including elevated levels of the stress hormone cortisol, can lead to significant long-term health problems for mothers and their infants. The objective of the proposed research is to test whether an innovative stress management intervention, offered during pregnancy, is effective in reducing stress and cortisol levels among low-income pregnant women. The results of the proposed work have substantial public health implications in helping to prevent the onset of stress-related health complications among mothers and their infants.

描述（由申请人提供）：如越来越多的研究所证明的那样，怀孕期间经历的压力可能会给母亲及其婴儿带来重大的长期健康问题。一种生物学机制在增加妇女在怀孕期间和产后期间患有压力相关的健康并发症的风险方面已被鉴定出来的一种生物学机制是压力激素皮质醇。但是，为了优化母体和婴儿健康结果，调节皮质醇的最佳方法几乎没有得到关注。拟议研究的目的是进行两臂；飞行员随机对照研究以测试产前认知行为应力管理（CBSM）干预在调节低收入孕妇皮质醇和应激水平方面的疗效。共有100名女性将被随机分为一个基于组的8周产前CBSM ARM（即认知应对和放松技能培训）或护理标准比较组（即通常的前和产后护理），以检查接受CBSM干预的妇女是否会显着降低妇女的妇女，并将其相对降低妇女的妇女，以降低妇女的分类和标准的武器。这项研究还将检查皮质醇中这些降低和应力水平是否通过行为改变过程（例如，自我效力提高以及对认知应对和放松技巧的使用）介导。该假设是根据首席研究者和研究合作者收集的初步数据提出的。通过形成性研究，这项试验性工作将在低收入孕妇中开发和经验测试产前CBSM应力管理干预措施，用于当地产前中心。拟议工作的结果具有很大的公共卫生影响，并有望促进我们对孕妇如何有效地使用这些认知应对和放松技巧来采用健康行为并产生变化，从而对其健康以及婴儿的健康产生积极影响。此外，拟议的研究将产生CBSM干预措施，该干预措施可以在社区环境中很容易进行，可扩展，并且成本相对较低。最后，这些结果将有助于确定那些通过这些创新的压力管理方法来表现特别好（或不良）的孕妇亚组。这对CBSM计划对个人需求和偏好的量身定制具有重要意义。 公共卫生相关性：正如越来越多的研究所证明的那样，怀孕期间经历了高水平的压力，包括压力激素皮质醇水平升高，可能会给母亲及其婴儿带来重大的长期健康问题。拟议研究的目的是测试怀孕期间提供的创新压力管理干预措施是否有效降低低收入孕妇的压力和皮质醇水平。拟议工作的结果具有实质性的公共卫生影响，以帮助防止母亲及其婴儿与压力相关的健康并发症发作。