The "Wings" Depressive Symptom Intervention for Latina Mothers

针对拉丁裔母亲的“翅膀”抑郁症状干预

• 批准号: 8075291
• 负责人: LINDA BEEBER
• 金额: $ 5.12万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8075291
• 关键词: Achievement; Address; Age; Aggressive behavior; Area; Behavioral; Case Management; Child; Chronic; Clinic; Clinical; Clinical Trials; Collection; Communities; County; DSM-IV; Data; Data Collection; Destinations; Development; Disease; Early treatment; Economics; Eligibility Determination; Emotional; Enrollment; Exposure to; Extended Family; Family; Head Start Program; Home environment; Immigration; Infant; Infant Development; Intervention; Intervention Studies; Interview; Language; Language Disorders; Latina; Latino; Learning; Link; Low income; Maintenance; Measures; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Modification; Mothers; North Carolina; Nurse Psychotherapist; Outcome; Parenting behavior; Parents; Participant; Peer Group; Population; Protein Structure Initiative; Protocols documentation; Psychiatric Nursing; Psychotherapy; Questionnaires; Randomized; Recruitment Activity; Recurrence; Research Project Grants; Safety; Sales; Schools; Screening procedure; Self Efficacy; Services; Social support; Societies; Staging; Stress; Structure; Symptoms; Testing; Toddler; Wing; Work; abstracting; center for epidemiological studies depression scale; clinically significant; coping; depressive symptoms; design; effective intervention; experience; improved; instrument; interpersonal conflict; intervention program; method development; post intervention; pressure; prevent; programs; randomized trial; social; stressor; training project; treatment as usual

Project Summary/Abstract LEP Latina mothers of infants and toddlers are confronted with chronic economic hardship and immigration- related stressors. As high as 64% experience clinically significant depressive symptoms, which limit their ability to offer developmental support to their infant or toddler. Infant/toddler exposure to maternal depressive symptoms has been linked to language deficits and persistent developmental lags, and in older children, conduct disorders and social aggression. Many "new destination" areas for Latinos in the US have inadequate bilingual mental health services and LEP Latina mothers cannot get treatment. The "Wings" intervention to reduce depressive symptoms had a significant impact in 80 Latina LEP mothers in Early Head Start (EHS). To prepare for a larger trial of the intervention, this study will finalize refinements to the intervention and test the feasibility, acceptability and safety of selected methods and protocols. The intervention is a 10-session, in-home modification of Interpersonal Psychotherapy (IPT) delivered by English-speaking advanced practice psychiatric nurses paired with bilingual, project-trained community interpreters. It is designed to help mothers reduce depressive symptoms, cope with stress, increase social support and parent more effectively. Refinements to the intervention that will be finalized include strategies to resolve interpersonal conflict and promote familismo [family unity], additional parenting guidance that supports Latino values of respeto [respectfulness] and educaci¿n [responsible actions], the addition of post- intervention maintenance sessions (PIMs) to prolong the reduction of symptoms and emphasis on helping mothers connect to existing community agencies to access peer and group social support. This study will also test protocols for a case management/control condition and a pre-enrollment mental health assessment; determine the feasibility of recruitment, screening and enrollment protocols and the administration of instruments not used in previous studies. Finally, the study will evaluate feasibility, acceptability and safety of the revised methods in 20 Latina mothers who score 16 or greater on the Center for Epidemiological Studies Depression Scale (CES-D) and who have infants or toddlers between 6 weeks and 36 months old recruited from community agencies. Participants will be randomized to the intervention or to a case management/control condition and measured over three collection points (baseline, 12 weeks and 6 months). Spanish versions of the Hamilton Rating Sale for Depression (HRSD) will be used along with other measures (PSI; CBCL; Ages and Stages Questionnaires - Social-Emotional; HSI-I, ARSMA-II, social support and self-efficacy). This study will support a larger randomized trial, and ultimately the integration of the "Wings" intervention into community clinics, early intervention programs and Latino- serving agencies.

项目概要/摘要 婴儿和幼儿的 LEP 拉丁裔母亲面临着长期的经济困难和移民问题 - 高达 64% 的人经历过临床上显着的抑郁症状，这限制了他们的生活。 为婴儿或幼儿接触母亲提供发育支持的能力。 抑郁症状与语言缺陷和持续发育迟缓有关，并且在老年人中 美国的许多拉丁裔“新目的地”地区都存在儿童、品行障碍和社会攻击行为等问题。 双语心理健康服务不足，LEP 拉丁裔母亲无法获得治疗。 减少抑郁症状的干预对早期 80 名拉丁裔 LEP 母亲产生了显着影响 为了准备更大规模的干预试验，本研究将最终完善干预措施。 干预并测试所选方法和方案的可行性、可接受性和安全性。 干预是对人际心理治疗 (IPT) 进行的 10 次家庭修改，由 讲英语的高级执业精神科护士与经过项目培训的双语社区配对 它旨在帮助母亲减轻抑郁症状、应对压力、增加社交能力。 更有效地支持和家长将最终确定的干预措施包括策略。 为了解决人际冲突并促进家庭团结，额外的育儿指导 支持拉丁裔价值观 respeto [尊重] 和 educaci¿ n [负责任的行动]，增加事后 干预维持课程（PIM）可延长症状的缓解时间并强调帮助 母亲们与现有的社区机构建立联系，以获得同伴和团体的社会支持。 还测试病例管理/控制条件和注册前心理健康的协议 评估；确定招募、筛选和注册方案的可行性以及 最后，该研究将评估可行性， 修订后的方法在中心得分 16 分或以上的 20 名拉丁裔母亲中的可接受性和安全性 适用于流行病学研究抑郁量表 (CES-D) 以及 6 周内有婴儿或幼儿的人 从社区机构招募的 36 个月大的参与者将被随机分配接受干预。 或根据病例管理/控制条件并在三个收集点进行测量（基线、12 周 和 6 个月）将同时使用汉密尔顿抑郁症评级出售 (HRSD) 的西班牙语版本。 与其他测量（PSI；CBCL；年龄和阶段问卷 - 社会情感；HSI-I、ARSMA-II、 社会支持和自我效能）。这项研究将支持更大规模的随机试验，并最终支持。 将“Wings”干预纳入社区诊所、早期干预计划和拉丁裔 服务机构。