Developing and testing a multi-component intervention to improve Perinatal Mental Health

开发和测试多成分干预措施以改善围产期心理健康

• 批准号: 10723985
• 负责人: Elysia Larson
• 金额: $ 17.69万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723985
• 关键词: Address; Adoption; Affect; Anxiety; Anxiety Disorders; Behavioral; Birth; Black Populations; COVID-19 pandemic; Caring; Child Psychiatry; Child Rearing; Client; Communities; Consult; Consultations; Coping Skills; Data; Data Collection; Dedications; Development; Education; Effectiveness; Emotional; Ensure; Equity; Evidence based intervention; Fostering; Foundations; Goals; Health Personnel; Health system; Individual; Infection; Intervention; Lead; Leadership; Link; Manuals; Massachusetts; Measures; Mental Depression; Mental Health; Mental Health Services; Mentored Research Scientist Development Award; Mentorship; Methods; Modeling; Modification; Mood Disorders; Moods; Morbidity - disease rate; Mothers; National Institute of Mental Health; Obstetrical Nursing; Outcome; Patients; Perinatal; Perinatal Care; Persons; Population; Positioning Attribute; Postpartum Period; Pregnancy Complications; Prevention approach; Provider; Psychiatrist; Qualitative Methods; Randomized; Reporting; Research; Research Methodology; Resources; Schedule; Service delivery model; Site; Specialist; Stress; Suicide; Symptoms; Techniques; Telephone; Testing; Training; Voice; Wait Time; Work; acceptability and feasibility; barrier to care; career; community based participatory research; community engaged research; effective intervention; experience; feasibility trial; healthcare community; implementation science; improved; innovation; intervention refinement; marginalization; marginalized community; multi-component intervention; overdose death; perinatal health; perinatal mental health; perinatal period; peripartum depression; pilot test; pregnancy related death; pregnant; prevent; preventive intervention; programs; psychosocial; racism; recruit; reduce symptoms; response; skills; social stigma; standard of care; success; therapy development; tool; uptake; women of color

Depression and anxiety are the most common complications of pregnancy and the postpartum period, affecting one in five birthing people. Despite effective interventions for prevention and treatment, most perinatal depression and anxiety is unprevented and untreated, especially among marginalized communities. The proposed research will work with doulas, perinatal people, and clinicians to co-develop and pilot test a multi- component intervention called “Doula Link for Perinatal Mental Health (Doula Link).” Doula Link builds from a national model of perinatal psychiatric access programs to create links to the community and direct delivery of behavioral support. This community-based participatory research will center the experiences and voices of marginalized communities with the goal of fostering high quality equitable care. In line with NIMH Strategic Goal 4, the overall goal for the proposed project is to develop and test an innovative service delivery model to reduce symptoms of perinatal depression and anxiety. This will be accomplished through three research aims: 1) To adapt and define the intervention components through iterative mixed-methods research with doulas, mental health specialists, and perinatal people who are representative of marginalized communities; 2) To administer and refine the intervention with doulas who will then offer the psychosocial intervention to their pregnant clients; 3) Assess the feasibility and accessibility of Doula Link using a pilot cluster-randomized controlled feasibility trial. This research will be conducted in tandem with advanced training and mentorship for the candidate. Training will target four specific training goals: 1) intervention development for perinatal mental health, 2) advanced qualitative methods for community-engaged research, 3) advanced methods for implementation science, and 4) leadership and professional development to lead multi-site studies. At the end of the proposed project, the candidate will have developed and piloted a version of Doula Link, which will include the following products: 1) doula-specific toolkit for Psychiatric Access Programs, 2) training manual for doulas to implement the psychosocial intervention, 3) fidelity measures, 4) critical data on intervention feasibility and acceptability, 5) recruitment, retention, and assessment response rates, and 6) estimates of intra-cluster correlation coefficient and effect size. The goal of this K01-Mentored Research Scientist Development Award is to prepare the candidate for an independent research career dedicated to developing and testing acceptable, feasible, scalable, equitable, and effective interventions to improve perinatal mental health. With the research, training, and mentorship gained during this K01, the candidate will acquire the data and advanced skills needed to develop an R01 application for a fully-powered trial and be positioned to become a leader in perinatal mental health implementation science research.

抑郁和焦虑是妊娠和产后期最常见的并发症，影响 尽管采取了有效的预防和治疗干预措施，但大多数围产期婴儿仍患有此病。 抑郁症和焦虑症得不到预防和治疗，特别是在边缘化社区中。 拟议的研究将与导乐师、围产期人群和新移民合作，共同开发和试点测试一种多 称为“围产期心理健康导乐链接（导乐链接）”的干预措施。 全国围产期精神病治疗方案模式，以建立与社区的联系并直接提供 这项基于社区的参与性研究将以人们的经验和声音为中心。 边缘化社区的目标是促进高质量的公平护理，符合 NIMH 战略。 目标 4，拟议项目的总体目标是开发和测试创新的服务交付模式，以 减少围产期抑郁和焦虑症状这将通过三个研究目标来实现： 1) 通过导乐的迭代混合方法研究来调整和定义干预措施， 心理健康专家和代表边缘化社区的围产期人士 2) 导乐师管理和完善干预措施，然后导乐师将为他们提供心理社会干预 3) 使用试点整群随机评估 Doula Link 的可行性和可及性 这项研究将与高级培训和指导同时进行。 培训将针对四个具体培训目标：1）围产期心理干预发展。 健康，2）社区参与研究的先进定性方法，3）先进的方法 实施科学，以及 4) 领导多地点研究的领导力和专业发展。 在拟议项目中，候选人将开发并试点 Doula Link 的一个版本，该版本将 包括以下产品：1) 精神科服务项目导乐专用工具包，2) 培训手册 导乐实施社会心理干预，3) 忠诚度措施，4) 干预的关键数据 可行性和可接受性，5) 招聘、保留和评估回复率，以及 6) 估计 这位 K01 指导研究科学家的目标。 发展奖旨在帮助候选人为致力于开发的独立研究生涯做好准备 并测试可接受的、可行的、可扩展的、公平的和有效的干预措施，以改善围产期心理 通过 K01 期间获得的研究、培训和指导，候选人将获得数据。 以及开发 R01 应用程序以进行全功能试验所需的高级技能，并定位于 成为围产期心理健康实施科学研究的领导者。