RESUMO
OBJECTIVE: Internet-based interventions may positively impact maternal symptoms of postnatal depression and anxiety. This study assessed the feasibility, acceptability, perceived usefulness, and preliminary effectiveness of an m-Health version of "What Were We Thinking?" (m-WWWT). METHODS: A mixed-methods with a 2-arm randomized parallel design was used. From a total of 477 women, 157 met the inclusion criteria. 128 first-time mothers of full-term infants, aged 4-10 weeks, who received health care at primary public health centers in Chile, were randomly assigned to the experimental (EG, n = 65) or control (CG, n = 63) groups; data of 104 of them (53 and 51, respectively) was analyzed. We used percentages and rates to measure feasibility outcomes and mixed analysis of variance (ANOVA) and latent class analyses (LCA) to assess preliminary effectiveness. Participants completed questionnaires on mental health, social support, and maternal self-efficacy upon recruitment and 3 months after completing the intervention. For the qualitative component, 12 women from the EG were interviewed. RESULTS: Quantitative results show good feasibility outcomes, such as high recruitment (82%), low attrition (EG = 12% and CG = 17%), and high follow-up (EG = 97% and CG = 91%) rates. Qualitative results indicate high acceptability and perceived usefulness of m-WWWT. Mixed ANOVA did not show significant differences between the groups (all p >.05). However, multinomial regression analysis in LCA showed that women with low baseline symptoms of depression and anxiety benefit from the intervention (B = 0.43, 95% confidence interval 1.09-2.16). CONCLUSION: m-WWWT is feasible to be implemented in Chile; future studies are needed to assess the intervention's effectiveness.
Assuntos
Depressão Pós-Parto , Intervenção Baseada em Internet , Humanos , Feminino , Depressão Pós-Parto/terapia , Depressão Pós-Parto/psicologia , Depressão/psicologia , Chile , Estudos de Viabilidade , Ansiedade/psicologiaRESUMO
The COVID-19 pandemic was a source of significant stress due to health and safety concerns and measures to control the virus' spread, such as mobility restrictions. This measure was especially demanding for parents with school aged children, who had to find new work-family balance as their children participate in online education while attempting to work remotely. To evaluate parents' stress trajectories during the pandemic, we conducted Ecological Momentary Assessments (EMAs) during lockdown for 29 days in 68 families in Santiago, Chile. In addition, we evaluated the role of educational level and income, co-parenting, and number of children in parents' stress trajectories. Our results showed that during the first weeks of lockdown expected protective factors (i.e., income and co-parental support) were not able to influence parents' daily stress management. Moreover, parents with higher educational levels reported worse stress adaptation than less educated parents. On the other hand, co-parental conflict was significantly associated with parent's stress. Our study captured an acute response to COVID-19 related challenges. This study contributes to understanding how parents adjust to stress during adverse circumstances such as the COVID-19 pandemic.
Assuntos
COVID-19 , Criança , Humanos , COVID-19/epidemiologia , Avaliação Momentânea Ecológica , Pandemias , Inquéritos e Questionários , Controle de Doenças TransmissíveisRESUMO
Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.
Assuntos
COVID-19 , Depressão Pós-Parto , Intervenção Baseada em Internet , Criança , Feminino , Humanos , Ansiedade/prevenção & controle , Chile , COVID-19/prevenção & controle , Depressão Pós-Parto/prevenção & controle , Estudos de Viabilidade , Mães/psicologia , PandemiasRESUMO
The pandemic outbreak in March 2020 and its associated sanitary regulations and restrictions triggered an abrupt and significant change for society in general and for families' organization in particular. In Chile, the Santiago Metropolitan District was under a strict lockdown that involved the closure of the entire educational system. From a systemic-family stress perspective, the impact of these changes might have consequences not only for each individual family member, but for the parental dynamic and, consequently, for children's well-being. This paper presents the results of a follow-up study showing changes in self-reported parental depression and the perceived home organization of mothers and fathers assessed at three different moments: before the pandemic, at the initial outbreak, and after 1 month of strict lockdown. Relevant moderators were explored using linear mixed models to understand the within-subject changes in mothers' and fathers' self-reports across the different assessment times. Financial strain, personality traits of self-criticism and dependency, previous parent-child quality interaction, recent major stressful events, and number of children are highlighted as relevant factors that moderate changes in home chaos and parental mental health perception. Significant risks and protective factors are described for fathers and mothers. The use of pre-pandemic measures as baseline levels enabled the identification of personal and family characteristics that were related to better outcomes. The results help increase our understanding of the sanitary regulations' impacts on the family system and identify vulnerability indicators that should be considered.
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Latent class analysis and multigroup mediation were used with 8,860 families in Chile to identify risk groups varying in socioeconomic status, family structure, and maternal depression, to determine whether profiles differed in children's development of externalizing problems (EP) from 35 to 61 months, and maternal parenting that predicted EP. Four groups were identified: one no-risk profile and three risk profiles, impoverished and undereducated, depressed and impoverished, and father-absent and impoverished. All classes differed in EP. Maternal emotional support and harsh parenting were differentially associated with the development of EP across the three risk groups, relative to the low-risk group. Thus, specific constellations of adversities differentially predicted children's EP and socialization processes mediating links between risk and EP. Implications are discussed.
Assuntos
Poder Familiar , Socialização , Criança , Chile/epidemiologia , HumanosRESUMO
This study used Latent Class Analysis to identify groups of children exposed to similar Home Language and Literacy Environments (HLLE) and explored whether belonging to a given HLLE group was related to children's language and early literacy growth from prekindergarten to kindergarten. Participants were 1,425 Chilean mothers and their children (Mage = 52.52 months at baseline) from low-socioeconomic status households. Four HLLE groups were identified, which were associated with different trajectories of language and early literacy development. Children from groups whose mothers either read and talk about past events with them or teach them letters in addition to reading and talking about past events, showed higher relative vocabulary and letter knowledge. Implications for research and interventions are discussed.