Project REACH: Preventing Postpartum Depression in Adolescent Mothers

REACH 项目：预防青春期母亲产后抑郁症

• 批准号: 8457146
• 负责人: MAUREEN G PHIPPS
• 金额: $ 53.31万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-02 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8457146
• 关键词: 20 year old; Address; Adherence; Adolescent; Age; Attention; Behavior; Behavior Therapy; Behavioral; Birth; Characteristics; Child; Child Behavior; Childhood; Clinical; Collaborations; Contraceptive methods; Development; Ethnic Origin; Evaluation; Evidence based program; Foundations; Funding; Future; Goals; Health; Health Status; Immunization Schedule; Infant; Interdisciplinary Study; Intervention; Intervention Studies; Knowledge; Lead; Life; Low income; Major Depressive Disorder; Maternal Age; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mind; Mood Disorders; Morbidity - disease rate; Mothers; National Institute of Mental Health; Outcome; Outcome Measure; Participant; Perinatal; Pilot Projects; Play; Population; Population Heterogeneity; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prenatal care; Prevention Research; Prevention program; Preventive Intervention; Psychotherapy; Public Health; Qualifying; Race; Randomized Controlled Trials; Research; Risk; Role; Sampling; Severities; Social support; Structure; Testing; Time; Treatment Efficacy; United States; Visit; Vulnerable Populations; Woman; base; care delivery; clinical care; depressive symptoms; design; experience; follow-up; improved; innovation; insight; maternal depression; novel; prenatal; prevent; programs; psychosocial; racial and ethnic; response; social; stressor; teenage mother; therapy development; young mother

DESCRIPTION (provided by applicant): More than 400,000 births in the US each year are to adolescent mothers and approximately 26-36% of these mothers experience postpartum depression (PPD), a condition associated with significant social and health morbidity. PPD puts adolescent mothers and their children at risk during an already challenging time in their lives and this hardship may be a major determinant of poor outcomes for these young mothers and their children. Depression in adolescent mothers may influence whether they engage in health-promoting behaviors both for themselves and their infants. Research to date has not focused on preventing PPD in adolescent mothers even though the potential for a positive public health impact is tremendous in this vulnerable population. The Project REACH application addresses the research objective outlined in PA 09-174: Women's Mental Health in Pregnancy and the Postpartum Period targeting intervention research to develop systematic knowledge about "psychosocial depression treatments for perinatal mood disorders" and "to develop new behavioral interventions for these conditions, in particular interventions that can be adapted to general medical or group settings." Further, this application specifically targets a population of women particularly vulnerable to PPD because of their young age, low-income and diverse ethnic/racial backgrounds. The long-term objective of Project REACH (Relax, Encourage, Appreciate, Communicate, Help) is to improve health outcomes for adolescent mothers and their children by preventing PPD. To accomplish this goal, a feasible and acceptable evidence-based program to prevent PPD in adolescent mothers will be evaluated for efficacy in a prenatal setting serving a diverse population of pregnant women. The Specific Aim of Project REACH is to conduct a randomized controlled trial to evaluate whether the intervention (Project REACH) compared with a didactic attention-control program reduces the risk of PPD in adolescent mothers. Project REACH is based on Interpersonal Psychotherapy and targets those factors that may play a significant role in the development of PPD in adolescent mothers (i.e., poor social support, role transitions and life stressors). The highly structured intervention is delivered as five sessions during pregnancy with one postpartum booster session. Participants are evaluated for depression at 6-weeks, 3-month, 6-months and 12-months postpartum. In addition to PPD outcomes, Project REACH proposes to assess the impact of the intervention on maternal-child bonding and health promoting behaviors. The collaborative interdisciplinary research team is uniquely qualified to lead this application as they have successfully developed and pilot tested the innovative behavioral prevention program to prevent PPD in adolescent mothers. Through careful evaluation and refinement, Project REACH has been tailored for collaboration with an integrated prenatal care program; and, if found to be efficacious, REACH has the potential for broad dissemination and acceptability in prenatal practice.

描述（由申请人提供）：每年在美国有400,000多个出生是对青少年母亲的，这些母亲中约有26-36％的母亲经历了产后抑郁症（PPD），这是与重大社会和健康发病率有关的疾病。 PPD使青春期母亲及其子女在生活中本来就充满挑战的时期处于危险之中，这可能是这些年轻母亲及其子女不良结果的主要决定因素。青少年母亲的抑郁可能会影响他们自己和婴儿是否从事促进健康的行为。迄今为止，研究并未集中于预防青少年母亲的PPD，即使在这一脆弱人群中产生积极的公共卫生影响的可能性是巨大的。 PA 09-174中概述的研究目标涉及的研究目标：妇女的心理健康和产后时期针对干预研究，以发展有关“围产期情绪障碍的心理社会抑郁症治疗”和“为这些病情开发新的行为干预措施的系统知识，特别是可以适应这些干预措施，尤其是可以适应一般医疗或集体设置。”此外，由于年轻，低收入和多样化的种族/种族背景，该应用程序专门针对了众多妇女，特别容易受到PPD的影响。项目覆盖率的长期目标（放松，鼓励，欣赏，交流，帮助）是通过预防PPD来改善青少年母亲及其子女的健康成果。为了实现这一目标，将评估一项可行且可接受的基于证据的计划，以防止在青少年母亲中PPD，以在为多样化的孕妇人群中的产前环境中评估有效性。项目覆盖率的具体目的是进行一项随机对照试验，以评估与教学注意力控制计划相比，干预措施（项目覆盖率）是否会降低青少年母亲的PPD风险。项目覆盖率基于人际心理治疗，并针对那些可能在青春期母亲的PPD发展中起重要作用的因素（即社会支持差，角色过渡和生活压力源）。高度结构化的干预措施是在怀孕期间通过一次产后助推器会议进行的五个课程。对参与者的抑郁症评估为6周，3个月，6个月和12个月的产后。除了PPD结果外，Project Reach还建议评估干预措施对母子纽带和健康促进行为的影响。协作跨学科研究团队具有独特的资格来领导这一应用程序，因为他们已经成功地开发并测试了创新的预防行为预防计划，以防止青春期母亲的PPD。通过仔细的评估和完善，已针对与综合产前护理计划的合作进行了量身定制的项目覆盖范围；而且，如果发现有效的话，覆盖范围有可能在产前实践中进行广泛的传播和可接受性。