Reducing Maternal Depression and Promoting Infant Social-Emotional Health and Development.

减少孕产妇抑郁症并促进婴儿社会情感健康和发展。

• 批准号: 10006834
• 负责人: Kathleen M Baggett
• 金额: $ 61.99万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10006834
• 关键词: Accounting; Address; Adoption; Age; Attitude; Awareness; Behavior; Behavioral; Belief; Books; Cellular Phone; Child Rearing; Chronic; Communities; Competence; Computers; Conflict (Psychology); Depressed mood; Development; Early Intervention; Effectiveness; Emotional; Evidence based intervention; Experimental Designs; Geography; Health; Home visitation; Human; Infant; Infant Behavior; Instruction; Intervention; Knowledge; Latino; Life Cycle Stages; Logistics; Low income; Maintenance; Medical; Mental Depression; Mental disorders; Minority; Mothers; Nursery Schools; Online Systems; Outcome; Parents; Participant; Plague; Play; Postpartum Period; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Research; Resources; Risk; Science; Services; Social support; Societies; Stress; Technology; Testing; Time; Woman; Work; arm; attentional control; cost; depressive symptoms; digital; disability; dosage; early life adversity; economic cost; emotional behavior; emotional functioning; experience; improved; infancy; infant outcome; innovation; intervention effect; maternal depression; prevent; programs; satisfaction; service delivery; skill acquisition; social; social relationships; societal costs; sound; treatment program

For infants facing early adversity, intervening early and targeting specific nurturing parent behaviors has proven to be effective in promoting healthy infant social-emotional trajectories. Sadly, maternal depression skyrockets during early infancy, especially for low-income women and interferes with maternal engagement in interventions shown to be effective generally in improving infant social-emotional outcomes. Maternal depression in the first year postpartum constitutes an enormous and costly public health concern with extensive and well-documented detrimental effects on infant parenting and infant life course trajectories. Maternal depression treatments operate in silos, separate from infant parent interventions that target specific parent behaviors shown to promote infant competencies. There is an absence of integrated interventions with demonstrated effectiveness in reducing both maternal depression and promoting infant parenting behavior that builds infant social-emotional competencies. To address the life course needs of depressed mothers and their infants, we need brief, accessible, and integrated interventions that target both maternal depression and specific nurturing parent behaviors shown to improve infant social-emotional trajectories. In our prior programmatic research, we have developed two separate web- based, remote coaching interventions for: (a) parent nurturing behaviors that improve infant outcomes (Baby- Net R34; R01), and (b) maternal depression (Mom-Net R34; R01). Compared to controls, the Baby- Net program demonstrated medium to large effects on observed nurturing parent behavior and on infant social- emotional competencies in the context of play and in the context of book activities. Mom-Net demonstrated low attrition and high levels of feasibility, program use, and satisfaction. Compared to controls, Mom-Net participants demonstrated significant reductions in depression and improved preschool parenting behavior. A substantial advantage of the web-based, remote coaching approach is that it overcomes multiple logistical barriers that often prevent low-income mothers from participating in community/home-visiting treatment programs. While Mom-Net exists for depressed mothers of preschoolers, it is not designed for infant parenting. Moreover, in Baby-Net studies, we found that maternal depression significantly impeded program progress and positive intervention effects. Thus, our prior research on web-based maternal depression and specific nurturing parenting behavior in infancy, provides a strong empirical basis to integrate salient Mom-Net depression content into the Baby-Net program to target depression and specific infant parenting behaviors that promote infant social-emotional competencies and trajectories. We will rigorously test the merged Your Strength-Your Baby (YSYB) intervention effects with 180 low-income mothers with depression and their infants via a 2-arm, intent-to-treat, randomized controlled trial.

对于面临早期逆境的婴儿，事实证明，早期介入并针对特定的养育父母行为，可以有效地促进健康的婴儿社会情感轨迹。可悲的是，在婴儿早期期间，孕产妇的抑郁症飞跃，尤其是对于低收入妇女而言，孕产妇参与干预措施通常可以有效地改善婴儿社会情感成果。产后第一年的母亲抑郁症构成了巨大且昂贵的公共卫生问题，对婴儿育儿和婴儿生活课程轨迹的广泛且有据可查的有害影响。孕产妇抑郁症治疗在孤岛中起作用，与婴儿父母的干预措施分开，这些干预措施针对特定的母亲行为促进婴儿能力。缺乏综合干预措施，在减少孕产妇抑郁和促进婴儿社会情感能力的婴儿育儿行为方面表现出了有效性。为了满足沮丧的母亲及其婴儿的生活过程，我们需要简短，可访问和综合的干预措施，这些干预措施针对孕产妇抑郁症和特定的养育父母行为，以改善婴儿的社会情感轨迹。在先前的程序化研究中，我们为：（a）父母培养行为，以改善婴儿结果（婴儿净R34; r01）和（b）母亲抑郁症（MOM-NET R34; R01）。与对照组相比，该婴儿计划在游戏活动和书籍活动的背景下对观察到的父母行为以及对婴儿的社会情感能力的培养和婴儿社会情感能力的影响很大。 MOM-NET表现出较低的流失和高水平的可行性，程序使用和满意度。与对照组相比，妈妈网络参与者表现出抑郁症的显着减少和改善的学龄前育儿行为。基于网络的远程教练方法的一个实质优势是，它克服了多个后勤障碍，这些障碍通常可以防止低收入母亲参加社区/家庭访问治疗计划。虽然妈妈网络存在于学龄前儿童的沮丧母亲，但它并不是为婴儿育儿而设计的。此外，在婴儿网络研究中，我们发现孕产妇抑郁症显着阻碍了计划的进步和积极的干预效果。因此，我们先前对基于Web的孕产妇抑郁症和婴儿期育儿行为的特定养育行为的研究提供了强大的经验基础，将显着的MOM-NET抑郁症含量整合到婴儿网络计划中，以靶向抑郁症和特定的婴儿育儿行为，从而促进婴儿社会情感能力和轨迹。我们将通过一项2臂，意图治疗的随机对照试验对180名低收入抑郁症及其婴儿进行严格测试与您的婴儿（YSYB）干预效果。

项目成果

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes.

• DOI: 10.3390/ijerph17238978
• 发表时间: 2020-12-02
• 期刊: International journal of environmental research and public health
• 作者: Baggett KM;Davis B;Sheeber LB;Ammerman RT;Mosley EA;Miller K;Feil EG
• 通讯作者: Feil EG

Depressed and Socioeconomically Disadvantaged Mothers' Progression Into a Randomized Controlled Mobile Mental Health and Parenting Intervention: A Descriptive Examination Prior to and During COVID-19.

• DOI: 10.3389/fpsyg.2021.719149
• 发表时间: 2021
• 期刊: Frontiers in psychology
• 影响因子: 3.8
• 作者: Baggett KM;Davis B;Mosley EA;Miller K;Leve C;Feil EG
• 通讯作者: Feil EG

Optimizing Social-Emotional-Communication Development in Infants of Mothers With Depression: Protocol for a Randomized Controlled Trial of a Mobile Intervention Targeting Depression and Responsive Parenting.

• DOI: 10.2196/31072
• 发表时间: 2021-08-18
• 期刊: JMIR research protocols
• 影响因子: 1.7
• 作者: Baggett KM;Davis B;Sheeber L;Miller K;Leve C;Mosley EA;Landry SH;Feil EG
• 通讯作者: Feil EG