Brock Rebecca L, O'Hara Michael W, Segre Lisa S
Department of Psychology, The University of Nebraska-Lincoln, Lincoln, NE, USA.
Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA.
Am J Community Psychol. 2017 Mar;59(1-2):172-183. doi: 10.1002/ajcp.12129.
Maternal depression is a prevalent public health problem, particularly for low-income mothers of young children. Intervention development efforts, which often focus on surmounting instrumental barriers to care, have not successfully engaged and retained women in treatment. Task-sharing approaches like Listening Visits (LV) could overcome key instrumental and psychological barriers by leveraging the access of trusted, community caregivers to deliver treatment. A recent randomized controlled trial (RCT) demonstrated the efficacy of LV delivered by non-mental-health providers as compared to usual care. The present report presents results from a follow-up phase of that RCT during which participants who had completed LV were followed for an additional 8 weeks and completed measures of depression and quality of life. In addition, participants who were initially randomized to the wait-list control group received LV and were assessed. Treatment gains previously observed in participants completing LV were enhanced during the 8-week follow-up period. Participants receiving LV during the follow-up period experienced significant improvement in depressive symptoms. Results demonstrate the sustainability of LV delivered by non-mental-health providers, and provide preliminary evidence for the replicability of this approach in a sample of predominately low-income pregnant women and mothers of young children.
产妇抑郁是一个普遍存在的公共卫生问题,对于低收入的幼儿母亲来说尤为如此。干预措施的开发工作通常侧重于克服获得护理的实际障碍,但未能成功促使女性参与并持续接受治疗。像倾听访问(LV)这样的任务分担方法可以通过利用值得信赖的社区护理人员提供治疗来克服关键的实际和心理障碍。最近一项随机对照试验(RCT)表明,与常规护理相比,由非心理健康提供者提供的倾听访问具有疗效。本报告展示了该随机对照试验随访阶段的结果,在此阶段,完成倾听访问的参与者被额外随访8周,并完成了抑郁和生活质量测量。此外,最初被随机分配到等待名单对照组的参与者接受了倾听访问并接受了评估。在8周的随访期内,之前在完成倾听访问的参与者中观察到的治疗效果得到了增强。在随访期接受倾听访问的参与者的抑郁症状有显著改善。结果证明了由非心理健康提供者提供倾听访问的可持续性,并为这种方法在主要为低收入孕妇和幼儿母亲的样本中的可复制性提供了初步证据。