Project REACH: Preventing Postpartum Depression in Adolescent Mothers

REACH 项目：预防青春期母亲产后抑郁症

基本信息

批准号：
9101837
负责人：
MAUREEN G PHIPPS
金额：
$ 52.11万
依托单位：
WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-08-02 至 2018-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9101837
关键词：
20 year old Address Adherence Adolescent Age Attention Behavior Behavior Therapy Behavioral Birth Characteristics Child Child Behavior Childhood Clinical Collaborations Contraceptive methods Development Ethnic Origin Evaluation Evidence based program Foundations Funding Future Goals Health Health Status Immunization Schedule Infant Interdisciplinary Study Intervention Intervention Studies Knowledge Lead Life Low income Major Depressive Disorder Maternal Age Mediator of activation protein Medical Mental Depression Mental Health Mind Mood Disorders Morbidity - disease rate Mothers National Institute of Mental Health Outcome Outcome Measure Participant Perinatal Pilot Projects Play Population Population Heterogeneity Postpartum Depression Postpartum Period Pregnancy Pregnant Women Prenatal care Prevention Research Prevention program Preventive Intervention Public Health Qualifying Race Randomized Controlled Trials Research Risk Role Sampling Severities Social support Structure Testing Time Treatment Efficacy United States Visit Vulnerable Populations Woman base care delivery clinical care depressive symptoms design experience follow-up improved innovation insight interpersonal therapy maternal depression novel prenatal prevent programs psychosocial racial and ethnic response social stressor teenage mother therapy development young mother

项目摘要

DESCRIPTION (provided by applicant): More than 400,000 births in the US each year are to adolescent mothers and approximately 26-36% of these mothers experience postpartum depression (PPD), a condition associated with significant social and health morbidity. PPD puts adolescent mothers and their children at risk during an already challenging time in their lives and this hardship may be a major determinant of poor outcomes for these young mothers and their children. Depression in adolescent mothers may influence whether they engage in health-promoting behaviors both for themselves and their infants. Research to date has not focused on preventing PPD in adolescent mothers even though the potential for a positive public health impact is tremendous in this vulnerable population. The Project REACH application addresses the research objective outlined in PA 09-174: Women's Mental Health in Pregnancy and the Postpartum Period targeting intervention research to develop systematic knowledge about "psychosocial depression treatments for perinatal mood disorders" and "to develop new behavioral interventions for these conditions, in particular interventions that can be adapted to general medical or group settings." Further, this application specifically targets a population of women particularly vulnerable to PPD because of their young age, low-income and diverse ethnic/racial backgrounds. The long-term objective of Project REACH (Relax, Encourage, Appreciate, Communicate, Help) is to improve health outcomes for adolescent mothers and their children by preventing PPD. To accomplish this goal, a feasible and acceptable evidence-based program to prevent PPD in adolescent mothers will be evaluated for efficacy in a prenatal setting serving a diverse population of pregnant women. The Specific Aim of Project REACH is to conduct a randomized controlled trial to evaluate whether the intervention (Project REACH) compared with a didactic attention-control program reduces the risk of PPD in adolescent mothers. Project REACH is based on Interpersonal Psychotherapy and targets those factors that may play a significant role in the development of PPD in adolescent mothers (i.e., poor social support, role transitions and life stressors). The highly structured intervention is delivered as five sessions during pregnancy with one postpartum booster session. Participants are evaluated for depression at 6-weeks, 3-month, 6-months and 12-months postpartum. In addition to PPD outcomes, Project REACH proposes to assess the impact of the intervention on maternal-child bonding and health promoting behaviors. The collaborative interdisciplinary research team is uniquely qualified to lead this application as they have successfully developed and pilot tested the innovative behavioral prevention program to prevent PPD in adolescent mothers. Through careful evaluation and refinement, Project REACH has been tailored for collaboration with an integrated prenatal care program; and, if found to be efficacious, REACH has the potential for broad dissemination and acceptability in prenatal practice.

描述（由申请人提供）：美国每年有超过 400,000 名青春期母亲分娩，其中大约 26-36% 的母亲患有产后抑郁症 (PPD)，这是一种与严重的社会和健康发病率相关的疾病。产后抑郁症使青春期母亲及其孩子在生命中本来就充满挑战的时期面临风险，这种困难可能是这些年轻母亲及其孩子结局不佳的一个主要决定因素。青春期母亲的抑郁症可能会影响她们是否为自己和婴儿采取促进健康的行为。迄今为止的研究并未集中于预防青少年母亲的产后抑郁症，尽管对这一弱势群体产生积极的公共卫生影响的潜力是巨大的。 REACH 项目应用程序解决了 PA 09-174 中概述的研究目标：女性妊娠期和产后期的心理健康，旨在进行干预研究，以开发有关“围产期情绪障碍的心理社会抑郁治疗”和“为这些围产期情绪障碍开发新的行为干预措施”的系统知识。条件，特别是可以适应一般医疗或团体环境的干预措施。”此外，该应用程序专门针对由于年轻、低收入和不同民族/种族背景而特别容易患产后抑郁症的女性群体。 REACH 项目（放松、鼓励、欣赏、沟通、帮助）的长期目标是通过预防产后抑郁症来改善青少年母亲及其子女的健康状况。为了实现这一目标，将评估一项可行且可接受的循证计划，以预防青少年母亲产后抑郁症，以服务于不同孕妇群体的产前环境中的效果。 REACH 项目的具体目标是进行一项随机对照试验，以评估干预措施（REACH 项目）与教学性注意力控制计划相比是否可以降低青少年母亲患产后抑郁症的风险。 REACH 项目以人际心理治疗为基础，针对那些可能在青少年母亲产后抑郁症发展中发挥重要作用的因素（即不良的社会支持、角色转换和生活压力源）。这种高度结构化的干预措施在怀孕期间分五次进行，并进行一次产后强化治疗。参与者在产后 6 周、3 个月、6 个月和 12 个月时接受抑郁症评估。除了 PPD 结果之外，REACH 项目还建议评估干预措施对母婴关系和健康促进行为的影响。跨学科协作研究团队拥有领导这项应用的独特资格，因为他们已成功开发并试点测试了创新的行为预防计划，以预防青春期母亲的产后抑郁症。经过仔细评估和完善，REACH 项目已针对与综合产前护理计划的合作进行了量身定制；而且，如果发现有效，REACH 就有可能在产前实践中广泛传播并被接受。