(provided by candidate): Maternal depression is a source for substantial morbidity for both mother and child. This K23 application outlines a mentored 5-year education and research plan, devoted to developing and studying a self- management support system for maternal depression in Early Head Start (EHS), a federally funded early child development program for low income families. The intervention, based on the Chronic Care Model, will involve the identification of mothers with depressive symptoms through standardized instruments, and a case-management system that involves motivational enhancement and problem solving therapy. Through these strategies-the latter of which is an evidence-based treatment for depression in and of itself-EHS caseworkers will link mothers to further evidence-based mental health services, such cognitive behavioral therapy and medication management, and provide subsequent ongoing support and reassessment.
The specific aims of the research plan are to: 1. conduct qualitative interviews with EHS mothers to determine the range of attitudes to having their own mental health addressed as part of their children's preschool experience; 2. conduct focus groups with EHS caseworkers to learn the personal and institutional barriers to participating in this type of case-management system; 3. develop, through a 9-month pilot intervention, the details of the case-management protocol; 4. conduct a quasi-experimental study of the system to test its effect on EHS mothers' receipt of services for depression, depressive symptoms, social functioning, quality of maternal teaching interactions with their children, and child health care utilization. The candidate will gain experience in qualitative and quantitative research methods, behavioral intervention design, systems approaches to mental health promotion, and analysis of parent-child interaction. Information and experience gained from this project will be used to design a longitudinal randomized controlled trial to study the effect of this system on both mothers' depressive symptoms and their children's developmental outcomes. ? ?
|Silverstein, Michael; Kistin, Caroline; Bair-Merritt, Megan et al. (2016) Avoidance as an obstacle to preventing depression among urban women at high risk for violent trauma. Arch Womens Ment Health 19:63-70|
|Feinberg, Emily; Donahue, Sara; Bliss, Robin et al. (2012) Maternal depressive symptoms and participation in early intervention services for young children. Matern Child Health J 16:336-45|
|Silverstein, Michael; Feinberg, Emily; Cabral, Howard et al. (2011) Potential impact of trauma on the ability to prevent depression among low-income mothers. Depress Anxiety 28:478-84|
|Feinberg, Emily; Silverstein, Michael; Donahue, Sara et al. (2011) The impact of race on participation in part C early intervention services. J Dev Behav Pediatr 32:284-91|
|Silverstein, Michael; Feinberg, Emily; Cabral, Howard et al. (2011) Problem-solving education to prevent depression among low-income mothers of preterm infants: a randomized controlled pilot trial. Arch Womens Ment Health 14:317-24|
|Silverstein, Michael; Feinberg, Emily; Sauder, Sara et al. (2010) Comorbid posttraumatic stress symptoms in an urban population of mothers screening positive for depression. Arch Pediatr Adolesc Med 164:778-9|
|Silverstein, Michael; Feinberg, Emily; Young, Robin et al. (2010) Maternal depression, perceptions of children's social aptitude and reported activity restriction among former very low birthweight infants. Arch Dis Child 95:521-5|
|Silverstein, Michael; Reid, Samere; DePeau, Kristina et al. (2010) Functional interpretations of sadness, stress and demoralization among an urban population of low-income mothers. Matern Child Health J 14:245-53|
|Silverstein, M; Augustyn, M; Young, R et al. (2009) The relationship between maternal depression, in-home violence and use of physical punishment: what is the role of child behaviour? Arch Dis Child 94:138-43|
|Silverstein, Michael; Guppy, Nicole; Young, Robin et al. (2009) Receipt of special education services following elementary school grade retention. Arch Pediatr Adolesc Med 163:547-53|
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