Robbins Lorraine B, Chang Mei-Wei, Ling Jiying, Brown Roger
College of Nursing, Michigan State University, MI, United States.
College of Nursing, The Ohio State University, OH, USA.
J Pediatr Perinatol Child Health. 2022;6(1):54-69. doi: 10.26502/jppch.74050090. Epub 2022 Jan 5.
Depressive symptoms are particularly prevalent among low-income overweight or obese mothers with young children, indicating the importance of understanding and addressing this serious health condition. Although lifestyle behavior interventions are promising for alleviating depressive symptoms in low-income overweight or obese mothers with young children, mechanisms underlying the association between these interventions and depressive symptoms in this priority population remain unknown.
A secondary analysis of data from a randomized controlled trial that tested a 16-week community-based lifestyle behavior intervention for low-income overweight or obese mothers with young children was conducted to examine whether autonomous motivation, coping self-efficacy, and emotional coping mediated the association between the intervention and depressive symptoms.
The analysis included 338 participants who completed data collection at baseline and immediately after the intervention. Participants responded to validated surveys measuring autonomous motivation, coping self-efficacy, emotional coping, and depressive symptoms. To test mediation effects, composite indicator structural equation modeling was performed adjusting for baseline measures. The proportion of maximum possible (POMP) scores in the outcome variable per unit change in the predictor variables was used to calculate effect size.
The intervention alleviated depressive symptoms ( = -2.42, = 0.015, POMP = -4.31%), and coping self-efficacy negatively and fully mediated the association between the intervention and depressive symptoms ( = -1.42, = 0.002, POMP = -2.53%). Autonomous motivation and emotional coping were not significant mediators.
Interventions aimed to alleviate depressive symptoms in low-income overweight or obese mothers with young children should include strategies to improve coping self-efficacy. However, continued research is needed to identify other mechanisms that may be contributing to the effect of lifestyle behavior interventions on depressive symptoms in this at-risk group. This information can then be used to simplify and strengthen the interventions and potentially lead to effective dissemination and implementation.
抑郁症状在低收入的超重或肥胖且育有幼儿的母亲中尤为普遍，这表明了解并解决这一严重健康问题的重要性。尽管生活方式行为干预有望减轻低收入的超重或肥胖且育有幼儿的母亲的抑郁症状，但这些干预措施与该重点人群抑郁症状之间关联的潜在机制仍不清楚。
对一项随机对照试验的数据进行二次分析，该试验对低收入的超重或肥胖且育有幼儿的母亲进行了为期16周的基于社区的生活方式行为干预，以检验自主动机、应对自我效能感和情绪应对是否介导了干预与抑郁症状之间的关联。
分析纳入了338名在基线和干预结束后立即完成数据收集的参与者。参与者对测量自主动机、应对自我效能感、情绪应对和抑郁症状的有效调查问卷做出回应。为了检验中介效应，进行了综合指标结构方程模型分析，并对基线测量进行了调整。使用预测变量每单位变化时结果变量中最大可能得分比例（POMP）来计算效应量。
干预减轻了抑郁症状（β = -2.42，P = 0.015，POMP = -4.31%），应对自我效能感对干预与抑郁症状之间的关联起到了负向且完全的中介作用（β = -1.42，P =
