Depressive symptoms are more prevalent, severe and persistent in low-income mothers as a function of complex life problems, lean resources and poor social support. In addition to limiting the mother's emotional availability to her infant/toddler, depressive symptoms block these mothers' escape from poverty by robbing their energy for school and job training, and diminishing their use of available enrichment programs for their child. This is especially insidious for the very youngest children - infants and toddlers - because they are the most developmentally vulnerable. Using a 2-group, repeated measures experimental design, this study will test a brief (5 month) intervention using a modification of Interpersonal Psychotherapy to help mothers effectively function in the presence of depressive symptoms, manage life issues, use social support and parent their infant or toddler. The study will take place in five Early Head Start child enrichment programs, 4 in North Carolina and 1 in New York. Mothers from these programs who have depressive symptoms (score 16 or greater on the Center for Epidemiological Studies Depression Scale (CES-D) and who have infants or toddlers between 6 weeks and 30 months old who are enrolled in Early Head Start will participate. The 226 mothers will be randomized to treatment and usual care/attention control groups and the effects will be measured over four collection points (baseline, 14 weeks, 22 and 26 weeks) using the Hamilton Rating Sale for Depression, Structured Clinical Interview for Depression (SCID), analysis of videotaped unstructured, in-home mother-infant/toddler interactions, Everyday Stressors Index, social support and use of EHS services. Three mediators (self-efficacy, proactive coping and social support seeking) and moderators (maternal characteristics [age, education, income], maternal health and maternal burden [number of children, child healthcare responsibilities, access to transportation, resource acquisition effort, job strain and debt]) will be analyzed for effect on the intervention outcomes. Few controlled interventions with high-risk mothers such as these have been done to date. The proposed study will address this gap by bringing an intervention specifically for depressive symptoms alongside of an already-existing early child intervention program. By helping these mothers better utilize Early Head Start resources, the positive benefits of the intervention can be maintained and thus result in lasting benefit for the child as well as the mother. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH065524-03
Application #
6879714
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Street, Linda L
Project Start
2003-06-01
Project End
2009-02-28
Budget Start
2005-03-01
Budget End
2007-02-28
Support Year
3
Fiscal Year
2005
Total Cost
$648,182
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Type
Schools of Nursing
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Yang, Jenny; Martinez, Maria; Schwartz, Todd A et al. (2017) What Is Being Measured? A Comparison of Two Depressive Symptom Severity Instruments with a Depression Diagnosis in Low-Income High-Risk Mothers. J Womens Health (Larchmt) 26:683-691
Dowell, Jo; Beeber, Linda; Schwartz, Todd (2015) Determining Intervention Fidelity From Chronological Field Notes. J Nurs Meas 23:67E-77
Beeber, Linda S; Schwartz, Todd A; Holditch-Davis, Diane et al. (2014) Interpersonal Psychotherapy With a Parenting Enhancement Adapted for In-Home Delivery in Early Head Start. Zero Three 34:35-44
Beeber, Linda S; Schwartz, Todd A; Martinez, Maria I et al. (2014) Depressive symptoms and compromised parenting in low-income mothers of infants and toddlers: distal and proximal risks. Res Nurs Health 37:276-91
Beeber, Linda S; Schwartz, Todd A; Holditch-Davis, Diane et al. (2013) Parenting enhancement, interpersonal psychotherapy to reduce depression in low-income mothers of infants and toddlers: a randomized trial. Nurs Res 62:82-90
Beeber, Linda S; Perreira, Krista M; Schwartz, Todd (2008) Supporting the mental health of mothers raising children in poverty: how do we target them for intervention studies? Ann N Y Acad Sci 1136:86-100
Beeber, Linda S; Cooper, Carolyn; Van Noy, Barbara E et al. (2007) Flying under the radar: engagement and retention of depressed low-income mothers in a mental health intervention. ANS Adv Nurs Sci 30:221-34
Beeber, Linda S; Canuso, Regina (2005) Strengthening social support for the low-income mother: five critical questions and a guide for intervention. J Obstet Gynecol Neonatal Nurs 34:769-76
Beeber, Linda S; Canuso, Regina; Emory, Sara (2004) Instrumental inputs: moving the interpersonal theory of nursing into practice. ANS Adv Nurs Sci 27:275-86