LEP Latina mothers of infants and toddlers are confronted with chronic economic hardship and immigration- related stressors. As high as 64% experience clinically significant depressive symptoms, which limit their ability to offer developmental support to their infant or toddler. Infant/toddler exposure to maternal depressive symptoms has been linked to language deficits and persistent developmental lags, and in older children, conduct disorders and social aggression. Many """"""""new destination"""""""" areas for Latinos in the US have inadequate bilingual mental health services and LEP Latina mothers cannot get treatment. The """"""""Wings"""""""" intervention to reduce depressive symptoms had a significant impact in 80 Latina LEP mothers in Early Head Start (EHS). To prepare for a larger trial of the intervention, this study will finalize refinements to the intervention and test the feasibility, acceptability and safety of selected methods and protocols. The intervention is a 10-session, in-home modification of Interpersonal Psychotherapy (IPT) delivered by English-speaking advanced practice psychiatric nurses paired with bilingual, project-trained community interpreters. It is designed to help mothers reduce depressive symptoms, cope with stress, increase social support and parent more effectively. Refinements to the intervention that will be finalized include strategies to resolve interpersonal conflict and promote familismo [family unity], additional parenting guidance that supports Latino values of respeto [respectfulness] and educaci?n [responsible actions], the addition of post- intervention maintenance sessions (PIMs) to prolong the reduction of symptoms and emphasis on helping mothers connect to existing community agencies to access peer and group social support. This study will also test protocols for a case management/control condition and a pre-enrollment mental health assessment;determine the feasibility of recruitment, screening and enrollment protocols and the administration of instruments not used in previous studies. Finally, the study will evaluate feasibility, acceptability and safety of the revised methods in 20 Latina mothers who score 16 or greater on the Center for Epidemiological Studies Depression Scale (CES-D) and who have infants or toddlers between 6 weeks and 36 months old recruited from community agencies. Participants will be randomized to the intervention or to a case management/control condition and measured over three collection points (baseline, 12 weeks and 6 months). Spanish versions of the Hamilton Rating Sale for Depression (HRSD) will be used along with other measures (PSI;CBCL;Ages and Stages Questionnaires - Social-Emotional;HSI-I, ARSMA-II, social support and self-efficacy). This study will support a larger randomized trial, and ultimately the integration of the """"""""Wings"""""""" intervention into community clinics, early intervention programs and Latino- serving agencies.

Public Health Relevance

The development of infants and toddlers may be harmed by exposure to depressive symptoms in their mother. This project will determine whether a short-term, in-home, intervention to help Spanish-speaking Latina mothers reduce their depressive symptoms is feasible and safe and whether the methods needed to test it on a larger scale can be carried out. Ultimately, by improving the mental health of these mothers, their infants and toddlers'development and adaptation to society will be enhanced.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
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Hill, Lauren D
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University of North Carolina Chapel Hill
Schools of Nursing
Chapel Hill
United States
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Matsuda, Yui; Martinez, Maria; Beeber, Linda S (2017) Caring as a Facilitator of Sensitive Research Studies with Immigrant Latino Families. Int J Hum Caring 21:26-31
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