Improving Preschool Outcomes by Addressing Maternal Depression in Head Start
Purpose
Within a research network of Head Start centers in Massachusetts, an efficacy trial of a stepped-care intervention (SCI) to address maternal depression, using intervention components that both prevent depression and help those in major depressive episode (MDE) engage with care, will be conducted. Both the prevention and engagement components of the model have strong, supportive randomized trial evidence for both their efficacy and safety; but they have yet to be synthesized and tested within a coordinated intervention, applicable to a broad population base. Stepped-care interventions are commonly used in mental health service projects, in which the intensity or type of service is calibrated to the severity of illness.
Condition
- Maternal Depression
Eligibility
- Eligible Ages
- All ages
- Eligible Genders
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Mother of a 0 to 5-year-old Head Start child, whose Head Start services will continue for at least 12 months following randomization - Mother endorses depressed mood or anhedonia on PHQ-9 (Patient Health Questionnaire-9) - Mother speaks English or Spanish - Mother is Medicaid beneficiary
Exclusion Criteria
- Mother with suicidal ideation - Mother with cognitive limitation
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Health Services Research
- Masking
- Double (Investigator, Outcomes Assessor)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Stepped-care intervention (SCI) group |
In the SCI group, mothers with low baseline depressive symptoms are offered the problem-solving education (PSE) prevention intervention, and mothers with greater depressive symptoms are offered Engagement Sessions. |
|
|
Active Comparator Usual care control group |
Families in the control group will receive usual Head Start services. |
|
Recruiting Locations
Boston, Massachusetts 02119
Amy Yule, MD
More Details
- Status
- Recruiting
- Sponsor
- Brown University
Detailed Description
This research study is a community-based efficacy trial (n=388) of a stepped-care model intervention to strengthen the capacity of Head Start to address parental depression and related adversities. Head Start mothers with symptoms of depressed mood or anhedonia, and their Head Start children, are enrolled across 12 Head Start centers. The research study aims to improve developmental outcomes for Head Start children by delivering stepped care intervention that incorporates depression prevention and linkage to formal mental health care to mothers. Mothers with low baseline depressive symptoms are offered a problem-solving intervention while mothers with greater symptoms are offered engagement sessions to link them to formal mental health services. At each problem-solving session participant's symptoms are assessed and if the symptoms meet pre-specified 'step-up' criteria, they are converted to Engagement sessions. Over 12 months, the intervention's effect will be assessed on a series of outcome measures for mothers; mechanisms by which maternal depression is theorized to impact young children; and child outcomes.