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通过社区卫生工作者干预降低低收入社区产后抑郁症风险

Reducing the Risk of Postpartum Depression in a Low-Income Community Through a Community Health Worker Intervention.

作者信息

Mundorf Christopher, Shankar Arti, Moran Tracy, Heller Sherry, Hassan Anna, Harville Emily, Lichtveld Maureen

机构信息

Department of Sociology, Hiram College, Hiram, OH, USA.

Department of Biostatistics & Bioinformatics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

出版信息

Matern Child Health J. 2018 Apr;22(4):520-528. doi: 10.1007/s10995-017-2419-4.

Abstract

Objectives To clarify the effectiveness of perinatal social support interventions in reducing postpartum depression among minority, low-income women. Methods The Transdisciplinary Research Consortium for Gulf Resilience on Women's Health supported a community-based participatory research project to improve perinatal health among low-income, first-time pregnant women living in a vulnerable Gulf Coast region. Community health workers (CHWs) were partnered with recruited women, and used a mix of mobile technology and home visits to develop a supportive relationship during the perinatal period. Results Women enrolled in the CHW-led intervention had lower (F: 2.38, p = 0.04) average postpartum depression scores (EPDS) 6 months postpartum than a comparison population. The difference, however, was not seen among women in the intervention group who reported relatively poor relationships with their CHWs. Conclusions for Practice Results reinforce the evidence that perinatal social support can affect postpartum depression outcomes. CHWs are increasingly utilized by public programs to reach at-risk populations. We discuss the potential efficacy of CHW programs, but also, the need to pair outreach with effective monitoring and evaluation of the relationship development between CHW and clients.

摘要

目的 阐明围产期社会支持干预措施在减少少数族裔低收入妇女产后抑郁方面的有效性。方法 海湾妇女健康恢复跨学科研究联盟支持了一个基于社区的参与性研究项目,以改善生活在脆弱的海湾沿岸地区的低收入初孕妇女生殖健康。社区卫生工作者(CHW)与招募的妇女结成伙伴关系,并在围产期利用移动技术和家访相结合的方式建立支持性关系。结果 参与由社区卫生工作者主导的干预措施的妇女在产后6个月时的平均产后抑郁评分(爱丁堡产后抑郁量表)低于对照组(F:2.38,p = 0.04)。然而,在报告与社区卫生工作者关系相对较差的干预组妇女中未观察到这种差异。实践结论 结果强化了围产期社会支持可影响产后抑郁结局的证据。公共项目越来越多地利用社区卫生工作者来接触高危人群。我们讨论了社区卫生工作者项目的潜在效果,同时也讨论了将外展服务与对社区卫生工作者和服务对象之间关系发展的有效监测和评估相结合的必要性。

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