The main aims of this proposed Exploratory Developmental Research Grant (R21: PA-10-069) are to: (1) develop a peer-delivered intervention by adapting well-established clinical strategies, (2) evaluate the feasibility and acceptability of the intervention in non-clinical, community-based settings from the perspective of key stakeholders (e.g. mothers, Family Peer Advocates (FPA), and supervisors), taking into account implementation supports for FPA to deliver the intervention in non-clinical settings;and (3) develop and test preliminary indicators of fidelity to the intervention. Low-income women of color and mothers who seek FPA- delivered services are at high risk for depression, yet their mental health needs are often undetected and unaddressed. They are unlikely to seek treatment on their own due to stigma and misperceptions about mental health and treatment. Active intervention strategies to assist mothers in identifying depressive symptoms and engage in clinical services are critical given the risks of maternal depression upon the child, mother, and family. FPAs, who are also caregivers of youth with psychiatric needs, are in a unique position to fulfill this role because they are viewed as trustworthy, credible role models who provide hope, empower participants and enhance satisfaction with services. However, many FPAs feel that they lack the skills and training to appropriately address caregivers'mental health needs. Thus, the goal of this project is to develop and evaluate an intervention to improve the identification of depression and linkage to mental health services for predominantly low-income, mothers of color caring for youth with psychiatric needs. To fulfill the study aims, the investigative team will be guided by the Deployment-Focused Model (DFM) of treatment development and testing, and adopt a participatory collaborative model to develop an intervention in partnership with a Family Advocacy and Research Board composed of policy-makers, consumers, researchers and FPA from the proposed study sties. We will train 10 FPA to deliver the intervention to 20 caregivers evidencing depressive symptoms, and gather data from mothers, FPA, and supervisors in order to investigate the feasibility and acceptability of the intervention. We will also develop and preliminarily test fidelity measures in anticipation of a larger effectiveness study. The proposed study is innovative in the following three ways: (1) it directly focuses on the mental health needs of mothers, recognizing the treatment of caregiver mental health as critical in its own right, (2) the clinical strategies are derived from well-established strategies typically delivered by clinicians, but have not yet been utilized by FPA in non-clinical settings, and, (3) this study adopts a community engagement approach, use of a Deployment-Focused Model, and strong linkages to NYS Office of Mental Health and a Family Advocacy and Research Board to ensure that if feasible, this model will likely be rapidly disseminated across the state. Data from this project will refine the intervention and protocol, and guided by the DFM, will inform a larger R34 or R01 study examining caregiver and child outcomes if warranted.

Public Health Relevance

The proposed study is relevant to public health considering the numerous adverse effects associated with untreated maternal depression on the child, parent, and family by developing and evaluating an innovative screening and linkage model to improve the identification of depression and linkage to mental health services.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21MH090146-02
Application #
8208086
Study Section
Mental Health Services in MH Specialty Settings (SRSP)
Program Officer
Pringle, Beverly
Project Start
2011-01-01
Project End
2012-05-31
Budget Start
2011-12-01
Budget End
2012-05-31
Support Year
2
Fiscal Year
2012
Total Cost
$47,605
Indirect Cost
$17,844
Name
New York State Psychiatric Institute
Department
Type
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
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Acri, Mary; Olin, S Serene; Burton, Geraldine et al. (2014) Innovations in the Identification and Referral of Mothers at Risk for Depression: Development of a Peer-to-Peer Model. J Child Fam Stud 23:837-843
Acri, Mary C; Palinkas, Larry; Hoagwood, Kimberly E et al. (2014) Interorganizational relationships among family support organizations and child mental health agencies. Adm Policy Ment Health 41:447-54
Lewandowski, R Eric; Acri, Mary C; Hoagwood, Kimberly E et al. (2013) Evidence for the management of adolescent depression. Pediatrics 132:e996-e1009
Cavaleri, Mary A; Olin, S Serene; Kim, Annie et al. (2011) Family support in prevention programs for children at risk for emotional/behavioral problems. Clin Child Fam Psychol Rev 14:399-412