Effects of a Prenatal Depression Preventive Intervention on Parenting and Young Children's Self-Regulation and Functioning (EPIC)

产前抑郁症预防干预对育儿和幼儿自我调节和功能的影响 (EPIC)

• 批准号: 10629270
• 负责人: Shiv Darius Tandon
• 金额: $ 64.21万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-07 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10629270
• 关键词: Address; Adolescent; Adopted; Adverse effects; Affect; Age; Age Months; Awareness; Behavioral; Child; Child Development; Child Health; Child Rearing; Clinical; Cognitive; Cognitive Therapy; Community based prevention; Data; Data Collection; Depressed mood; Development; Eligibility Determination; Enrollment; Ethnic Origin; Etiology; Exhibits; Family; Fathers; Feeling; Fostering; Funding; Future; Home; Home visitation; Informal Social Control; Intervention; Knowledge; Link; Low income; Major Depressive Disorder; Maternal Behavior; Maternal Health; Maternal and Child Health; Measurement; Medial; Mediating; Mental Health; Methods; Modeling; Mothers; Nursery Schools; Observational Study; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Patient-Focused Outcomes; Performance; Personal Satisfaction; Play; Postpartum Period; Preventive; Public Health; Randomized, Controlled Trials; Research Institute; Research Personnel; Role; Sample Size; Sampling; Science; Services; Site; Societies; Surveys; Testing; Thinking; Time; United States; Woman; Work; antepartum depression; base; causal model; critical period; depressive symptoms; early childhood; ethnic diversity; evidence base; follow-up; group intervention; improved; informant; innovation; intervention effect; intervention participants; low socioeconomic status; maternal depression; maternal outcome; mood regulation; motherhood; neurodevelopment; offspring; parental influence; performance based measurement; peripartum depression; prenatal; prevent; preventive intervention; programs; racial diversity; racial minority; recruit; skill acquisition; skills; sociodemographic factors; sociodemographic variables; theories; trial enrollment

PROJECT SUMMARY The proposed R01 project (EPIC) examines whether a prenatal depression prevention intervention—Mothers and Babies (MB)—improves parenting practices and child self-regulation through 54 months of age. We build on an existing cluster randomized controlled trial that enrolled 874 diverse, low-income women from 36 home visiting (HV) programs. We anticipate 598 of these women will be eligible for EPIC (489 intervention, 109 control) and we will enroll an additional 260 control participants as part of this R01, for a total sample of 858. We will also enroll 429 fathers. Perinatal depression is consistently linked to poor parenting practices and poor child self-regulation. This project builds on previous work that has demonstrated MB’s effects on improving maternal mental health outcomes and will examine the intervention’s longer-term impact on parenting and child self-regulation from 30-54 months of age. Intervention participants will have received the six-week MB intervention delivered in a group format in addition to usual HV services while control participants will have only received HV services. Data collection for the R01 includes maternal self-report with all 858 participants every six months, beginning at 30 months postpartum and continuing until 54 months postpartum. An intensive sub- study of parenting and child development will occur at 36, 42, and 48 months for a subset of 460 participants (230 intervention, 230 control). Paternal self-report surveys will occur at 30, 42, and 54 months. There are three specific aims. First, we test the hypothesis that MB improves parenting and child self-regulatory skill acquisition through 54 months of age. We will use intent-to-treat as well as propensity score adjusted analysis. Second, we test hypotheses about the maternal mechanisms by which MB influences parenting and child self- regulation. We hypothesize that MB intervention effects will be mediated by core skills targeted by MB—in particular, increased awareness of thoughts and feelings and increases in mood regulation—as these cognitive-behavioral skills are deficient in mothers with depressive symptoms and compromise mothers’ ability to engage in parenting practices that promote young children’s self-regulation. Third, we will examine fathers’ and other key sociodemographic variables’ role in moderating the impact of MB on mother’s parenting and the child’s self-regulation. The public health significance and innovation of this project is substantial. Addressing maternal mental health has been identified as a highly impactful enhancement to HV programs. If, as expected, we are able to generate a robust science base that precisely identifies mechanisms and outcomes impacted by the intervention in young children among our racially and ethnically diverse sample, HV programs currently using MB are likely to enhance their programmatic outcomes. Moreover, given the large number of HV programs that could adopt MB nationally, findings from this study can provide powerful data suggesting that MB become integrated into their core set of services.

项目摘要 拟议的R01项目（EPIC）检查是否是预防产前抑郁症干预措施 和婴儿（MB） - 在54个月大时，育儿做法和儿童自我调节。我们建造 在现有的集群随机对照试验中，该试验招募了来自36家家庭的874名潜水员，低收入妇女 访问（HV）程序。我们预计这些妇女中有598名将符合EPIC的资格（489次干预，109 控制），我们将作为R01的一部分招募260个对照参与者，总样本为858。 我们还将注册429名父亲。围产期抑郁症始终与育儿做法不佳有关 儿童自我调节。该项目以先前的工作为基础，该工作证明了MB对改进的影响 孕产妇的心理健康成果，并将检查干预措施对育儿和儿童的长期影响 从30-54个月大的自我调节。干预参与者将获得六周的MB 除了通常的HV服务外，还以组格式提供干预措施，而控制参与者只有 收到了HV服务。 R01的数据收集包括Mater自我报告 六个月，从产后30个月开始，一直持续到产后54个月。一个密集的子 - 育儿和儿童发展的研究将在460个参与者中进行36、42和48个月的研究 （230干预，230控制）。 Patanal自我报告调查将在30、42和54个月进行。有 三个具体目标。首先，我们检验了MB提高育儿和儿童自我调节技能的假设 通过54个月大的收购。我们将使用意图对治疗以及承诺得分调整后的分析。 其次，我们检验了有关母体机制影响育儿和儿童自我的假设 规定。我们假设MB干预效应将由MB针对的核心技能介导 特别是，人们对思想和感受的意识增加，情绪调节的增加，就像这些 认知行为技巧缺乏抑郁症状的母亲，使母亲的能力妥协 从事养育养育方式，以促进幼儿的自我调节。第三，我们将检查父亲的 以及其他关键的社会人口统计学变量在调节MB对母亲育儿和育儿的影响方面的作用 孩子的自我调节。该项目的公共卫生意义和创新是很大的。寻址 孕产妇的心理健康已被确定为对HV计划的高度影响力。如果， 预期，我们能够产生一个稳健的科学基础，以确定机制和结果 HV计划受到我们种族和种族多样化样本的干预的影响 目前使用MB可能会增强其程序化结果。而且，考虑到大量 可以在全国范围内采用MB的HV计划，这项研究的发现可以提供强大的数据表明 MB被整合到他们的核心服务集中。