Prenatal Yoga to Prevent Postpartum Depression (PRY-D)

产前瑜伽预防产后抑郁症 (PRY-D)

基本信息

批准号：
10723544
负责人：
Amy Michele Loree
金额：
$ 68.3万
依托单位：
HENRY FORD HEALTH SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-03 至 2026-07-02
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10723544
关键词：
Administrator Affect Behavior Black race Body Image Child Childhood Cost Savings Data Development Disease Effectiveness of Interventions Emotional Enrollment Evidence based practice Exclusion Fatigue Focus Groups Foundations Future Health Health Services Accessibility Health system Healthcare Systems High Risk Woman Hybrids Infant Infant Health Intervention Knowledge Logistics Measures Mediating Mediator Mental Depression Mental Health Mental Health Services Mental disorders Methodology Minority Women Morbidity - disease rate Not Hispanic or Latino Participant Patients Phase Physical activity Postpartum Depression Postpartum Period Pregnancy Pregnant Women Prenatal care Prevention Preventive Provider Public Health Randomized Randomized, Controlled Trials Recording of previous events Research Risk Risk Factors Services Stress Surveys Target Populations Techniques Time Use Effectiveness Vaginal delivery procedure Woman Women&apos s Health Work Yoga acceptability and feasibility adverse outcome antepartum depression associated symptom depressive symptoms effectiveness evaluation effectiveness research effectiveness testing effectiveness trial effectiveness/implementation trial ethnic diversity ethnic minority evidence base exercise intervention experience fetal follow-up group intervention high risk population implementation barriers implementation facilitators implementation intervention improved individual patient intervention delivery intervention refinement metropolitan mindfulness patient oriented perinatal mental health phenomenological models pilot test post intervention pregnant prenatal prevent preventive intervention primary outcome psychologic racial diversity racial minority racial minority population recruit risk prediction satisfaction systematic review treatment as usual virtual virtual delivery

项目摘要

PROJECT ABSTRACT Postpartum depression (PPD) affects 13% of women and is associated with maternal, fetal/infant, and childhood morbidity. Though risk factors are multifactorial, a history of depression strongly predicts risk of PPD, and women of racial/ethnic minority status are especially vulnerable. Although psychological interventions exist for the prevention of PPD, a yoga-based intervention to prevent PPD among at-risk women utilizes a similar theoretical foundation (i.e., mindfulness), may be more acceptable to women of minority status, and may confer additional physical activity benefits. Yoga interventions in pregnancy have been shown to be efficacious for depression, although pragmatic research is needed to evaluate these types of interventions in a way that facilitates external validity. The purpose of this R34 Pilot Effectiveness Trial is to determine the effectiveness of using a virtually delivered prenatal yoga intervention for the prevention of PPD among at-risk women in a diverse health care system and explore preliminary factors which influence implementation of the intervention. To this end, we have gathered a research team with content, intervention, statistical, and methodological expertise who will collaboratively execute the proposed project. In the proposed study, Phase 1 will evaluate facilitators and barriers to intervention implementation among patient, clinician, and health system stakeholders, followed by an open trial, and Phase 2 will include conducting an 8-session pilot randomized controlled trial to assess the feasibility and acceptability of the proposed prenatal yoga intervention among women with a history of depression, as well as the onset and course of PPD and mediating factors. The specific aims are to: 1) Optimize delivery of a yoga intervention within a healthcare system to prevent PPD through examining facilitators and barriers of implementation, 2) Examine feasibility, acceptability and satisfaction of the intervention within a health care system, and 3) Evaluate preliminary effectiveness of the intervention on PPD and proposed mechanisms. For Phase 1, separate focus groups with patient stakeholders and clinician and administrative stakeholders from Henry Ford Health will inform intervention implementation, and an open trial to refine and optimize the intervention. For Phase 2, women with a history of depression who are 8-28 weeks pregnant will be randomized to the intervention group (n=24) or treatment-as-usual (n=24) and will complete survey measures at baseline, post-intervention, and 1 and 3 months postpartum. It is hypothesized that the intervention will be feasible and acceptable, engage women of racial/ethnic minority status, and contribute to lower rates of PPD onset. Embodiment and mindfulness are the proposed mediators. Findings from this study will provide preliminary data to inform a fully powered hybrid type 2 effectiveness- implementation trial. The potential knowledge gained from this study can facilitate prevention efforts for PPD and ameliorate the adverse public health impact of this disorder.

项目摘要产后抑郁症（PPD）影响13％的妇女，与母亲，胎儿/婴儿和童年的发病率。尽管风险因素是多因素的，但抑郁史的历史强烈预测了PPD的风险，种族/族裔少数民族地位的妇女特别容易受到伤害。尽管存在心理干预措施为了预防PPD，基于瑜伽的干预措施可防止处于危险中的妇女中的PPD 理论基础（即正念），可能对少数族裔妇女更容易接受，并且可能赋予其他体育锻炼益处。已经证明瑜伽干预措施有效对于抑郁症，尽管需要务实的研究来评估这些类型的干预措施促进外部有效性。这项R34飞行员有效性试验的目的是确定使用几乎交付的产前瑜伽干预措施预防处于高危妇女中的PPD 多样化的医疗保健系统并探索影响干预实施的初步因素。为此，我们聚集了一个研究团队，具有内容，干预，统计和方法论专业知识将合作执行拟议的项目。在拟议的研究中，第1阶段将评估患者，临床医生和卫生系统之间进行干预实施的促进者和障碍利益相关者，然后进行开放试验，第2阶段将包括进行8届会议飞行员对照试验评估拟议产前瑜伽干预的可行性和可接受性有抑郁史的妇女以及PPD的发作和过程和中介因素。这具体目的是：1）优化在医疗保健系统中提供瑜伽干预以防止PPD 通过检查促进者和实施障碍，2）检查可行性，可接受性和对医疗保健系统中的干预满意，3）评估初步有效性干预PPD和提议的机制。对于第1阶段，与患者利益相关者分开的焦点小组亨利·福特健康（Henry Ford Health）的临床医生和行政利益相关者将为干预实施提供信息，并进行开放试验，以完善和优化干预措施。对于第二阶段，有抑郁史的女性怀孕的8-28周将被随机分为干预组（n = 24）或治疗 - 常常（n = 24），并且将在基线，干预后以及产后1和3个月的情况下完成调查措施。这是假设干预将是可行和可接受的，使种族/族裔少数民族妇女与状态，并导致PPD发作的速度较低。实施和正念是拟议的调解人。这项研究的发现将提供初步数据，以告知全功率的Hybrid 2型有效性 - 实施审判。这项研究所获得的潜在知识可以促进PPD的预防工作并改善这种疾病的不利公共卫生影响。