160 lines
5.2 KiB
YAML
160 lines
5.2 KiB
YAML
type: article
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abstract: 'Background: Postpartum depression is highly prevalent in low-income
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women and has significant health and mental health effects on mother and
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child. Home visiting (HV) programs provide services to large numbers of
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perinatal women in the United States and are a logical setting for
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delivering mental health services. Although there are interventions that
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reduce the risk of developing postpartum depression among low-income
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women, none have used nonhealth or nonmental health professionals as
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interventionists.
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Objective: This study aimed to outline the protocol of a cluster
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randomized trial funded by the Patient-Centered Outcomes Research
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Institute that evaluates whether the Mothers and Babies (MB) group
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intervention, when led by paraprofessional home visitors, is more
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efficacious than usual care. It will also examine if MB, when led by
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home visitors, is not inferior to MB delivered by mental health
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professionals (MHPs). MB has previously demonstrated efficacy when
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delivered by MHPs, and pilot work indicated promising results using home
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visitors to deliver the intervention.
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Methods: A cluster randomized trial is being conducted with 38 HV
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programs. Sixteen HV programs will deliver MB using MHPs, 16 will
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deliver MB using paraprofessional home visitors, and 6 will deliver
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usual HV services. The study employs a modified covariate-constrained
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randomization design at the site level. We anticipate recruiting 933
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women aged >= 16 years enrolled in HV programs, who are 33 or more
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weeks'' gestation and speak either English or Spanish. Women in the 2
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intervention arms will receive the 6-session MB group intervention.
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Baseline, postintervention, 12-week postpartum, and 24-week postpartum
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assessments will be conducted to assess client outcomes. The primary
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outcome will be the change in Quick Inventory of Depressive
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Symptomatology Self-Report 16 scores from baseline to 24-week follow-up.
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Secondary outcomes associated with core MB content will also be
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examined. Semistructured interviews will be conducted with home visitors
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and MHPs who are group facilitators and 90 study participants to gain
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data on intervention successes and challenges. Analyses will proceed at
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the participant level. Primary analyses for depressive symptoms score at
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24 weeks postpartum will involve a linear mixed model, controlling for
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baseline symptoms and other covariates, and random effects to account
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for clustering.
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Results: We have recruited 838 women through the end of August 2018.
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Recruitment will be completed at the end of September 2018.
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Conclusions: There is considerable potential to disseminate MB to HV
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programs throughout the United States. Should our results demonstrate
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home visitor efficacy when compared with usual care and/noninferiority
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between home visitors and MHPs in improving mental health outcomes, no
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additional financial resources would be required for the existing HV
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staff to implement MB. Should this study determine that home visitors
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are less effective than MHPs, we will generate more wide-scale evidence
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on MB effectiveness when led by MHPs.'
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affiliation: 'Jensen, JK (Corresponding Author), Northwestern Univ, Ctr Community
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Hlth, Inst Publ Hlth \& Med, Feinberg Sch Med, 750 N Lake Shore Dr,Suite 680, Chicago,
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IL 60611 USA.
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Jensen, Jessica K.; Diebold, Alicia; Segovia, Melissa; Degillio, Aria; Solano-Martinez,
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Jesus; Tandon, S. Darius, Northwestern Univ, Ctr Community Hlth, Inst Publ Hlth
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\& Med, Feinberg Sch Med, 750 N Lake Shore Dr,Suite 680, Chicago, IL 60611 USA.
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Ciolino, Jody D., Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago,
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IL 60611 USA.'
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article-number: e11624
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author: Jensen, Jessica K. and Ciolino, Jody D. and Diebold, Alicia and Segovia, Melissa
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and Degillio, Aria and Solano-Martinez, Jesus and Tandon, S. Darius
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author-email: jessica.jensen@northwestern.edu
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author_list:
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- family: Jensen
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given: Jessica K.
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- family: Ciolino
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given: Jody D.
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- family: Diebold
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given: Alicia
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- family: Segovia
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given: Melissa
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- family: Degillio
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given: Aria
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- family: Solano-Martinez
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given: Jesus
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- family: Tandon
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given: S. Darius
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da: '2023-09-28'
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doi: 10.2196/11624
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files: []
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issn: 1929-0748
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journal: JMIR RESEARCH PROTOCOLS
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keywords: 'depression; postpartum; pregnancy; randomized controlled trial;
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community health'
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keywords-plus: 'IN-HOME CBT; LOW-INCOME; POSTPARTUM DEPRESSION; SYMPTOMS; SCALE;
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INFANTS; PERCEPTIONS; OUTCOMES; EVENTS'
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language: English
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month: NOV
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number: '11'
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number-of-cited-references: '44'
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orcid-numbers: 'Johnson, Jessica/0000-0001-9482-7225
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Diebold, Alicia/0000-0002-1085-9105
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Tandon, Darius/0000-0002-3243-903X
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Solano-Martinez, Jesus/0000-0002-3826-6408'
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papis_id: eac6fc92d0d106077ef82f2aaaa4fcf3
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ref: Jensen2018comparingeffectivene
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times-cited: '11'
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title: 'Comparing the Effectiveness of Clinicians and Paraprofessionals to Reduce
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Disparities in Perinatal Depression via the Mothers and Babies Course: Protocol
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for a Cluster-Randomized Controlled Trial'
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unique-id: WOS:000452201800011
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '7'
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web-of-science-categories: 'Health Care Sciences \& Services; Public, Environmental
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\& Occupational
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Health'
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year: '2018'
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