The final resubmission of a Mentored Patient-Oriented Career Development Award Application (K23) to support Dr. Lisa Segre's development as an academic research scientist with expertise in the development of perinatal depression treatments for low-income and ethnic minority women. Dr. Segre intends to obtain additional training through formal coursework, directed readings under supervision of her mentor, and direct interactions with members of her external advisory panel while pursuing a program of research to develop new treatments for perinatal depression. Perinatal depression is a serious disorder affecting approximately 13% of new mothers, with low-income and African-American women particularly at risk. Depression also has a pervasive and long-lasting impact on the physical, social-emotional, and cognitive development of children of depressed mothers. Dr. Segre's research will focus on the implementation and subsequent evaluation of supportive listening/problem solving (SUPS), a treatment with established effectiveness in the United Kingdom. This treatment is provided by non-threatening professionals, delivered in the home, and conveys an important sense of mutual respect. Dr. Segre intends to import, implement, and evaluate the effectiveness of this treatment for depressed low- income and ethnic minority women who are unlikely, unwilling, or unable to seek more traditional treatment from mental health professionals. A special emphasis will be placed on adapting the treatment to the context of the US mental health and social service system, as well as evaluating the treatment's effectiveness. The central hypotheses of the Phase II treatment evaluation trial are (1) that supportive listening/problem solving (SL/PS) will be significantly more effective than standard enhanced case management in reducing depressive symptoms at the end of treatment and follow-up, (2) SL/PS will be significantly more effective than standard enhanced case management in improving social adjustment at the end of treatment and follow-up, (3) clients and case managers will find SL/PS to be an acceptable treatment, and (4) participation in SL/PS will be associated with significantly more use of professional mental health services than participation in standard enhanced case management. ? ? ?
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