Goldenberg Shira M, Ramage Kaylee, Martinez-Torteya Cecilia, Pitpitan Eileen, Rosenblum Katherine, Hernandez Chelsie, Alvarez Monica, Rangel Gudelia, Bojorquez-Chapela Ietza
School of Public Health, San Diego State University, San Diego, California, USA
School of Public Health, University of Tennesse, Knoxville, Tennessee, USA.
BMJ Open. 2025 Jan 28;15(1):e094917. doi: 10.1136/bmjopen-2024-094917.
Migrant women in transit face high risk of developing mental health problems such as depression and anxiety, driven by gendered social-structural factors including violence, social isolation, migration uncertainty, limited access to services and gender inequities. Although migrant women who endure such conditions have high need for mental health prevention, few evidence-based interventions are tailored to this population. Moreover, while women and children's mental health are interconnected, few mental health interventions address parenting needs. The aim of this study is to pilot-test a novel parenting and mental health prevention intervention for migrant mothers with young children (MMC) in Tijuana, Mexico, including (a) assessing acceptability; (b) estimating effect sizes on symptoms of depression, anxiety, and parenting stress; (c) identifying which theory-based mechanisms of action predict changes in outcomes; and (d) identifying factors associated with differential intervention response.
'Mamá Empoderada' (Mom Power) is a theory-based, trauma-informed group intervention to promote mental health and responsive parenting among mothers with young children (0-5 years). This is an evidence-based intervention that has been previously evaluated in the USA and has been recently adapted for Spanish-speaking mothers. We have recently adapted this intervention for MMC in Mexico and will conduct a pilot randomised controlled trial (RCT) of the intervention with MMC (n=100; N=50; N=50). The intervention group (IG) will receive 10 group and three individual sessions addressing attachment-based parenting skills, linkage to resources (eg, food, shelter), social support, and self-care and resilience over a 5-week period. The control group will receive standard of care programming and will be offered participation in the intervention following completion. Both groups will complete baseline and exit surveys, as well as follow-up surveys at 2, 4 and 6 months postintervention. Statistical analyses will compare primary (ie, symptoms of depression and anxiety; parenting stress) and intermediate outcomes (eg, resilience, service utilisation) by exposure to intervention condition.
This study is approved by the San Diego State University and El Colegio de la Frontera Norte Institutional Research Boards. Findings will inform a larger trial to evaluate intervention efficacy. In collaboration with our community partners, results will be disseminated via peer-reviewed publications; presentations; and plain-language reports, infographics, and presentations to community, clinical, and policy audiences. If efficacious, this intervention is highly promising as a novel, low-cost, and feasible model that could be implemented in border settings in Mexico, the USA and elsewhere. Amid rising population displacement and prolonged and traumatic migration journeys, this study addresses an urgent need for scalable and tailored mental health prevention for MMC in border contexts.
NCT06468046.
处于迁徙过程中的移民女性面临着患上抑郁症和焦虑症等心理健康问题的高风险，这是由暴力、社会孤立、移民不确定性、服务获取有限以及性别不平等这些性别化的社会结构因素所驱动的。尽管忍受这些状况的移民女性对心理健康预防有很高的需求，但很少有基于证据的干预措施是针对这一人群量身定制的。此外，虽然妇女和儿童的心理健康相互关联，但很少有心理健康干预措施涉及育儿需求。本研究的目的是对墨西哥蒂华纳市针对有幼儿的移民母亲（MMC）的一种新型育儿和心理健康预防干预措施进行试点测试，包括：（a）评估可接受性；（b）估计对抑郁、焦虑症状和育儿压力的效应大小；（c）确定哪些基于理论的作用机制能预测结果的变化；以及（d）确定与不同干预反应相关的因素。
“赋权妈妈”（Mom Power）是一种基于理论且考虑到创伤因素的团体干预措施，旨在促进有幼儿（0至5岁）的母亲的心理健康和积极育儿。这是一种基于证据的干预措施，此前已在美国进行过评估，最近已针对讲西班牙语的母亲进行了调整。我们最近已将此干预措施调整后应用于墨西哥的MMC，并将对MMC进行该干预措施的试点随机对照试验（RCT）（n = 每组100人；N = 干预组50人；N = 对照组50人）。干预组（IG）将在5周内接受10次团体课程和3次个体辅导课程，内容涉及基于依恋的育儿技巧、与资源（如食物、住所）的联系、社会支持以及自我护理和恢复力。对照组将接受标准护理方案，并在完成后可参与干预。两组都将完成基线调查和退出调查，以及干预后2个月、4个月和6个月时的随访调查。统计分析将通过干预条件暴露情况比较主要结果（即抑郁和焦虑症状；育儿压力）和中间结果（如恢复力、服务利用情况）。
本研究已获得圣地亚哥州立大学和北边境学院机构研究委员会批准。研究结果将为评估干预效果的更大规模试验提供信息。我们将与社区合作伙伴合作，通过同行评审出版物、报告、通俗易懂的报告、信息图表以及向社区、临床和政策受众的展示来传播研究结果。如果该干预措施有效，作为一种新颖、低成本且可行的模式，它极有希望在墨西哥、美国及其他地区的边境地区实施。在人口流离失所不断增加以及移民旅程漫长且充满创伤的情况下，本研究满足了边境地区对MMC进行可扩展且量身定制的心理健康预防的迫切需求。
NCT06468046
