This application is submitted is in response to PAR-09-173: Pilot Intervention and Services Research Grants (R34). We propose to use this grant mechanism to address three priority areas of the NIMH including decreasing the morbidity associated with depression, improving the mental health of females, and reducing the racial disparity in mental health. We address these issues by developing a novel approach to preventing depression in preadolescent African American girls growing up in urban, low-income environments.
The specific aims for the proposed application are to: 1) Develop methods and infrastructure for carrying out tests of proof-of-principle, and 2) Establish proof-of principle through evidence of feasibility and acceptability and preliminary studies of efficacy and determination of settings for deployment. Approach: Our approach will be to target individual and interpersonal vulnerabilities that have been shown to confer risk for depression in our existing research on African American girls living in low- income, urban settings. Specifically, we aim to increase assertiveness and active coping in order to reduce early emerging depressive symptoms during the preadolescent period. In addition, we propose that increasing interpersonal connectedness with the mother via maternal engagement in the prevention program is necessary to yield effects that generalize and are maintained. Investigators: The Principal Investigators, Drs. Kathryn Keenan and Kathryn Grant, are among the leading researchers in the field of developmental psychopathology who focus on children living in urban poverty. They are currently testing developmental models of depression in girls growing up in poverty. The present application is a joint venture in which their collective expertise in depression research and recent interest in translating their empirical findings to the prevention of depression will be applied. Innovation: The three novel aspects of our approach to preventing depression in females are targeting the preadolescent period, deriving individual vulnerabilities from existing datasets to target in the prevention program, using the mother as the method of delivery of the preventive intervention, and addressing barriers that have limited participation of low-income urban African American families in treatment. Public Health Relevance: Achievement of the aims described in this application will be the first step toward a major advancement in the prevention of depressive disorders for a population who is at highest risk for disorder and is least likely to receive mental health services, and has been underrepresented in preventive intervention research. Preventing the onset of depressive disorders in adolescent girls is one of the most promising avenues toward reducing the morbidity associated with depression for females.
Depressive disorders are among the leading contributors to disability and mortality in women around the world, rivaling cardiovascular disease. Therefore, preventing depression in females would result in an enormous improvement in women's health. The development of effective preventive interventions has been challenging, especially for African American girls living in poverty. These girls are at high risk for developing depression and are among the least likely to seek or receive mental health services. The aims of the present study are to: 1) Develop methods and infrastructure for carrying out tests of proof-of-principle, and 2) Establish proof-of principle through evidence of feasibility and acceptability and preliminary studies of efficacy and determination of settings for deployment.