Adapting a novel mental health prevention intervention for migrant mothers with young children in a humanitarian setting

在人道主义环境中为有幼儿的移民母亲采用新颖的心理健康预防干预措施

• 批准号: 10730411
• 负责人: IETZA BOJORQUEZ
• 金额: $ 61.57万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-16 至 2026-08-15
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730411
• 关键词: Address; Anxiety; Border Community; Border Crossings; Child; Child Care; Child Mental Health; Child Rearing; Conflict (Psychology); Control Groups; Cultural Sensitivity; Development; Economics; Equity; Evidence based intervention; Face; Focus Groups; Food; Future; Gender; Goals; Health; Health Services Accessibility; Housing; Immigration; Individual; Intervention; Intervention Studies; Link; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mental health promotion; Mexico; Migrant; Migration Policy; Mothers; National Institute of Mental Health; Outcome; Pilot Projects; Policies; Politics; Population; Post-Traumatic Stress Disorders; Prevention; Protocols documentation; Randomized, Controlled Trials; Reporting; Resources; Shelter facility; Social isolation; Social support; Strategic Planning; Stress; Surveys; Testing; Time; Translating; Trauma; Travel; Uncertainty; Underserved Population; Violence; Woman; Work; Writing; climate change; demographics; depressive symptoms; disparity reduction; efficacy trial; evidence base; experience; follow-up; group intervention; high risk; improved; intervention refinement; migration; multi-component intervention; novel; pilot test; post intervention; preventive intervention; programs; promote resilience; protective effect; reduce symptoms; resilience; response; selective prevention; social structure; standard of care; stressor; structural determinants; theories; trauma exposure; trauma symptom

PROJECT SUMMARY/ABSTRACT The goal of this pilot study is to adapt and pilot-test a novel mental health prevention intervention for migrant mothers with young children (MMC) in a humanitarian setting. Global migration is rising at record-high rates, with the number of women traveling with children continuing to rise at the U.S.-Mexico border. Tijuana, Mexico is located at the busiest land border crossing globally and faces an unprecedented humanitarian crisis resulting from displacement due to violence, political conflict, lack of economic opportunity, and climate change, exacerbated by migration policies that have forced hundreds of thousands of migrants to wait in Mexico under prolonged and unsafe conditions. Migrant women in transit in such contexts face high risk of developing mental disorders such as depression and anxiety, driven by gendered social-structural factors including violence, social isolation, migration uncertainty, and limited access to services. Although migrants in transit who endure such conditions have high need for mental health prevention, few evidence-based interventions are tailored to migrant women in transit. Moreover, while women and children’s mental health in humanitarian contexts are interconnected, few mental health interventions address parenting needs. We propose to adapt ‘Mamá Empoderada’ [Mom Power] - a theory-based, trauma-informed group intervention to promote mental health and positive parenting among mothers with young children (0-5 years) for the first time with MMC. This multi- component intervention includes a parenting program alongside activities to address social-structural vulnerabilities (e.g., connection to resources, strengthening social support). It has demonstrated efficacy on reduced parenting stress and mental health symptoms for trauma-exposed U.S. mothers and has recently been translated into Spanish. Our specific aims are to 1) Adapt, pre-test, and refine ‘Mamá Empoderada’ with MMC in a humanitarian context; 2) Conduct a pilot study of the adapted intervention to determine acceptability and estimate effect sizes on symptoms of depression, anxiety, and parenting stress; and 3) Explore which theory-based mechanisms of action predict changes in symptoms of depression, anxiety, and parenting stress, and identify factors associated with differential intervention response. We will conduct focus groups and pre- testing to adapt and refine the intervention, and conduct a pilot RCT of the adapted intervention with MMC (N=100; Ntreatment=50; Ncontrol=50). The intervention group (IG) will receive trauma-informed group and individual sessions on parenting, linkage to resources (e.g., food, shelter), social support, and resilience. The control group will receive written intervention materials, standard of care programming, and participate in the intervention following completion of the study by the IG (i.e., after 6 months). Both groups will complete baseline and exit surveys, as well as follow-up surveys at 3- and 6- months post-intervention. Amid rising population displacement and prolonged and traumatic migration journeys, this study addresses an urgent need for scalable and tailored mental health prevention for MMC in transit in humanitarian contexts.

项目摘要/摘要 这项试点研究的目的是适应和试点测试，以预防新型的心理健康干预措施 在人道主义环境中，有孩子的母亲（MMC）。全球迁移以创纪录的速度上升， 随着儿童旅行的妇女人数继续在美国 - 墨西哥边境上升。墨西哥蒂华纳 位于全球最繁忙的陆地边境过境点，面临着前所未有的人道主义危机 由于由于暴力，政治冲突，缺乏经济机会和气候变化而引起的流离失所， 被迫使数十万移民在墨西哥等待的移民政策加剧了 长期和不安全的条件。在这种情况下，移民妇女在这种情况下面临着高尚的心理风险 由性别社会结构因素驱动的抑郁症和焦虑等疾病，包括暴力， 社会隔离，迁移不确定性和对服务的访问有限。虽然忍受过境的移民 这种情况非常需要预防心理健康，很少有循证干预措施量身定制 移民妇女在过境中。而且，尽管在人道主义背景下妇女和儿童的心理健康是 相互联系，很少有心理健康干预措施满足育儿需求。我们建议适应‘Mamá empoderada’[妈妈权力] - 一种基于理论的，具有创伤的小组干预，以促进心理健康 与MMC首次有年幼子女（0-5岁）的母亲的积极育儿。这个多 组件干预包括一个育儿计划以及活动以解决社会结构 漏洞（例如，与资源的联系，加强社会支持）。它已经证明了效率 减少了暴露于创伤的美国母亲的育儿压力和心理健康症状，最近 我们被翻译成西班牙语。我们的具体目的是1）与 在人道主义背景下的MMC； 2）对改编干预措施进行试点研究以确定可接受性 并估计效应大小对抑郁症，动画和育儿压力的症状； 3）探索哪个 基于理论的作用机制可以预测抑郁症，动画和育儿压力的症状的变化， 并确定与差异干预响应相关的因素。我们将举办焦点小组和前 测试以适应和完善干预措施，并使用MMC进行改编的干预 （n = 100; ntreatment = 50; ncontrol = 50）。干预组（IG）将接受创伤的组和个人 育儿，与资源联系（例如食物，住所），社会支持和韧性的会议。控件 小组将获得书面干预材料，护理标准编程，并参加 IG完成研究后的干预措施（即6个月后）。两组将完成 干预后3个月和6个月，基线和退出调查以及随访调查。在上升 这项研究解决了人口流离失所以及长期和创伤的迁移之旅，迫切需要 用于在人道主义背景下过境中MMC的可扩展和量身定制的心理健康预防。