Mom & Baby Net

Full project title: Your Strength, Your Baby: Web-Based Remote Coaching to Reduce Maternal Depression and Promote Infant Social-Emotional Health and Development

Project timeline: 09/01/2016 – 08/31/2021


Abstract

For infants facing early adversity, intervening early and targeting specific nurturing parent behaviors has proven to be effective in promoting healthy infant social-emotional trajectories. Sadly, maternal depression skyrockets during early infancy, especially for low-income women [1-3] and interferes with maternal engagement in interventions shown to be effective generally in improving infant social-emotional outcomes [7,8,16]. Maternal depression in the first year postpartum constitutes an enormous and costly public health concern with extensive and well-documented detrimental effects on infant parenting and infant life course trajectories [4-6]. Maternal depression treatments operate in silos, separate from infant parent interventions that target specific parent behaviors shown to promote infant competencies. There is an absence of integrated interventions with demonstrated effectiveness in reducing both maternal depression and promoting infant parenting behavior that builds infant social-emotional competencies [8-11]. To address the life course needs of depressed mothers and their infants, we need brief, accessible, and integrated interventions that target both maternal depression and specific nurturing parent behaviors shown to improve infant social-emotional trajectories. In our prior programmatic research, we have developed two separate web- based, remote coaching interventions for: (a) parent nurturing behaviors that improve infant outcomes (Baby- Net R34; R01) [13], and (b) maternal depression (Mom-Net R34; R01) [14]. Compared to controls, the Baby- Net program demonstrated medium to large effects on observed nurturing parent behavior and on infant social- emotional competencies in the context of play [13] and in the context of book activities [15]. Mom-Net demonstrated low attrition and high levels of feasibility, program use, and satisfaction [14]. Compared to controls, Mom-Net participants demonstrated significant reductions in depression and improved preschool parenting behavior [14]. A substantial advantage of the web-based, remote coaching approach is that it overcomes multiple logistical barriers that often prevent low-income mothers from participating in community/home-visiting treatment programs [2]. While Mom-Net exists for depressed mothers of preschoolers, it is not designed for infant parenting. Moreover, in Baby-Net studies, we found that maternal depression significantly impeded program progress and positive intervention effects. Thus, our prior research on web-based maternal depression and specific nurturing parenting behavior in infancy, provides a strong empirical basis to integrate salient Mom-Net depression content into the Baby-Net program to target depression and specific infant parenting behaviors that promote infant social-emotional competencies and trajectories. We will rigorously test the merged Your Strength-Your Baby (YSYB) intervention effects with 180 low-income mothers with depression and their infants via a 2-arm, intent-to-treat, randomized controlled trial.

References

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  2. McDaniel, M. & Lowenstein, C. (2013). Depression in low-income mothers of young children: Are they getting the treatment they need? Research Report. Washington DC: The Urban Institute.

  3. Wentzel-Rochester, M. (2010). Poverty raises risk of postpartum depression. Published in Futurity, University of Pittsburgh, University of Rochester. http://www.futurity.org/poverty-raises-risk-of-postpartum-depression/

  4. Ammerman, R. T., Putnam, F. W., Bosse, N. R., Teeters, A. R., & Van Ginkel, J. B. (2010). Maternal depression in home visitation: A systematic review. Aggression and Violent Behavior, 15(3), 191-200. doi:10.1016/j.avb.2009.12.002

  5. Mitra, M., Iezzoni, L. I., Zhang, J., Long-Bellil, L. M., Smeltzer, S. C., & Barton, B. A. (2015). Prevalence and risk factors for postpartum depression symptoms among women with disabilities. Maternal and Child Health Journal, 19(2), 362-372. doi:10.1007/s10995-014-1518-8

  6. Gress-Smith, J. L., Luecken, L. J., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal And Child Health Journal, 16(4), 887-893. doi:10.1007/s10995-011-0812-y

  7. Easterbrooks, M. A., Bartlett, J. D., Raskin, M., Goldberg, J., Contreras, M. M., Kotake, C., & ... Jacobs, F. H. (2013). Limiting home visiting effects: maternal depression as a moderator of child maltreatment. Pediatrics, 132 Suppl 2S126-S133. doi:10.1542/peds.2013-1021K

  8. Ammerman, R. T., Putnam, F. W., Teeters, A. R., & Van Ginkel, J. B. (2014a). Moving beyond depression: A collaborative approach to treating maternal depression in home visiting. Zero to Three Journal, 34, 20-27.

  9. Beeber, L. S., Holditch-Davis, D., Belyea, M. J., Funk, S. G., & Canuso, R. (2004). In-Home Intervention for Depressive Symptoms with Low-Income Mothers of Infants and Toddlers in the United States. Health Care For Women International, 25(6), 561-580. doi:10.1080/07399330490444830

  10. Beeber, L. S., Holditch-Davis, D., Perreira, K., Schwartz, T. A., Lewis, V., Blanchard, H., & ... Davis Goldman, B. (2010). Short-term in-home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers. Research In Nursing & Health, 33(1), 60-76.

  11. Chazan-Cohen, R., Ayoub, C., Pan, B. A., Roggman, L., Raikes, H., McKelvey, L., & ... Hart, A. (2007). It takes time: Impacts on Early Head Start that lead to reductions in maternal depression two years later. Infant Mental Health Journal, 28(2), 151-170. doi:10.1002/imhj.20127

  12. Feil, E. G., Baggett, K. M., Davis, B., Sheeber, L., Landry, S., Carta, J., et al. (2008). Expanding the reach of preventive interventions: Development of an Internet-based training for parents of infants. Child Maltreatment, 13(4), 334-346. PMCID: PMC2744504

  13. Baggett, K. M., Davis, B., Feil, E. G., Sheeber, L., Landry, S., Carta, J., et al. (2010). Technologies for expanding the reach of evidence-based interventions: Preliminary results for promoting social- emotional development in early childhood. Topics in Early Childhood Special Education, 29(4), 226-238

  14. Sheeber, L. B., Seeley, J. R., Feil, E.G., Davis, B., Sorensen, E. D., Kosty, D. B., & Lewinsohn, P. M. (2012). Development and pilot evaluation of an internet-facilitated cognitive-behavioral intervention for maternal depression. Journal of Consulting and Clinical Psychology, 80, 739-749. doi:10.1037/a0028820

  15. Feil, E., G., Landry, S. H., Baggett, K. M., Davis, B., Sheeber, L., Leve, C. (under review). A randomized controlled trial of an Internet-based translation of an empirically-validated intervention for low-Income mothers of infants to meet the 30-million word gap. Journal of Pediatrics.