Prenatal depression is assrous, deleterious maternal and child health outcomes. Pregnant women have expressed a need for help in identifying and treating their depressive symptoms. Healthcare providers play a significant role in managing (i.e. identifying and treating/referring to care) prenatal depression as they are often the sole exposure to mental health resources for women. However, many providers may not be meeting these recommendations. Identifying women who are exhibiting depressive symptomatology and providing guidance based on evidence-based practices and/or utilizing linkages to mental health specialists are all integral to providing optimal patient-centered care. This study will conduct a pilot, randomized-controlled trial to test the preliminary effects of an online training with a diverse group of providers on the management of prenatal depression.
The present study intends to test an evidence-based, online training for a diverse group of providers on how to manage prenatal depression. Providers will be recruited from two states, Colorado and Virginia.
Our online training provides an overview of the harmful effects of prenatal depression on numerous maternal and child outcomes, as well as provides a framework that uses the 5As model (i.e. Assess, Advise, Agree, Assist and Arrange) to teach providers how to 1) assess for depression, 2) advise the patient on treatment options, 3) agree on a treatment plan, 4) assist patient in any problem solving related to obtaining treatment, and 5) arrange for supports for the patient (e.g. link patients to mental health resources in the community).
My Baby, My Move+ (MBMM+, 2019-2021) is a peer-led wellness intervention which aims to reduce excessive gestational weight gain (EGWG) by targeting prenatal physical activity, mood, and sleep quality. Up to 50% of pregnant women in the U.S. gain weight in excess of the Institute of Medicine guidelines. EGWG leads to poor maternal and child outcomes. It also sets the stage for long-term overweight/obesity for both mother and child.
A pilot randomized controlled 2 arm trial (MBMM+ intervention; Baby Basics program) will be conducted. Up to 100 pregnant women (50 intervention arm, 50 control arm) will be recruited from the Denver Metro and surrounding areas. Women in the intervention arm will participate in the 12-week MBMM+ intervention. The intervention will be offered both virtually and in-person. The overall goal of the MBMM+ intervention is to instill healthy habits (e.g., physical activity, good sleep hygiene, stress management) during and beyond pregnancy. Findings from this study will be used to inform a future, larger randomized trial.
Past research suggests that maternal depression during the pre- and post-natal periods is positively associated with obesity in early and middle childhood; however, the findings vary by timing and duration of exposure. Additionally, not all mothers suffering from depression will experience the same detrimental maternal and child health outcomes. Internal and external factors foster resilience, or positive adaptation to adversity, and can promote maternal mental health during these early critical periods.
Consideration of the determinants of obesity within a broader multi-level framework emphasize the upstream influences of maternal
mental health and resilience beginning very early in the life course. The FRAME project will have significant impacts on women’s health. If accumulation of maternal depression from the prenatal period through five-years of age is more predictive of childhood development outcomes compared to exposure solely during the prenatal period, the Life Course Health Development model can be used to explicate the ways in which adversity and resilience may aggregate over time and affect the intergenerational transmission of poor mental health. Additionally, findings may strengthen and expand evidence-based research related to mental health by targeting internal and external resilience supports for mothers.
This proposal’s objective is to investigate the feasibility of remote facilitation of a mindfulness-based intervention among a sample of pregnant women living in Colorado. Current research suggests that COVID-19 has amplified perinatal mood disorders
via stress related to uncertainty surrounding risk and exposure, a perceived lack of control, and lack of social supports and connectedness. This is a unique opportunity to pilot test the feasibility of an innovative mindfulness-based intervention
that can address these concerns and promote adaptive coping during this type of stressful event. Implementation and evaluation of remote mindfulness-based interventions are of paramount importance to inform how practitioners can promote the mental
and physical of pregnant and postpartum women. Findings from this study will begin to inform how prenatal MBIs may be feasibly delivered via remote platforms, mechanisms of action that impact prenatal depression, stress, and anxiety, and potential
for sustained positive mental and physical health impacts into the postpartum period.
The Rocky Mountain Prevention Research Center's core research project is designed to reduce the intergenerational transmission of adverse childhood experiences (ACEs) in the San Luis Valley (SLV) of Colorado, which are modifiable risk factors that have a profound and lasting effect on a person’s health. To accomplish this, a community-engaged, stakeholder-driven, multi-level intervention, entitled STANCE is being implemented.
The STANCE intervention has three primary components:
The primary effectiveness outcomes will be evaluated using a stepped wedge cluster randomized design conducted in ~15 ECE centers (~730 children). A systems change approach that marries preschools, community organizations, government agencies, policy-makers, and researchers, will increase the chances for success for vulnerable children prior to the compounding effects of health problems caused by ACEs.
The Colorado Department of Health and Environment (CDPHE) Positive Activities Lead to Success (PALS), and the Rocky Mountain Prevention Research Center (RMPRC) are collaborating to reduce the impact of ACEs and mental health illnesses in the San Luis Valley. PALs is a licensed after-school and summer children program for children ages 5 to 10 combating instability in their home. The mission of PALS is to provide children who have experienced trauma and ACEs a structured environment. The environment of PALS supports social-emotional learning, creativity, exploration, and nurture.
This collaboration between CDPHE, PALs, and the RMPRC aims to achieve three main goals. First, PALs will provide a modified, intense version of their program. This intensified version will provide increased one-on-one time for the children with a PALS’s staffer. Second, PALs will host monthly workshops for parents in the San Luis Valley (SLV) with each focused on different topics including parenting knowledge, skillsets, competence, and emotional regulations. Third, PALs will connect parents who experienced high ACEs/mental health illnesses to behavioral health telemedicine at The Children’s Hospital in Aurora, Colorado. While PALs will be implementing these three goals, the RMPRC will conduct a program evaluation where the team will evaluate both the intensified program and monthly workshops, as well as evaluating the impact of the behavioral telehealth medicine on the parents.