Adapting a novel mental health prevention intervention for in-transit mothers with young children

NIH RePORTER · NIH · R34 · $615,668 · view on reporter.nih.gov ↗

Abstract

The goal of this pilot study is to adapt and pilot-test a novel mental health prevention intervention for in-transit mothers with young children (MMC). Population mobility is rising at record-high rates, with the number of women traveling with children continuing to rise. The city of Tijuana, Mexico is located at the busiest land crossing globally and faces an unprecedented crisis resulting primarily from displacement due to violence, conflict, and lack of economic opportunity, exacerbated by policies that have resulted in mobile populations having to wait in Mexico under prolonged and unsafe conditions. In-transit women in such contexts face high risk of developing mental disorders such as depression and anxiety, driven by violence, social isolation, uncertainty, and limited access to services. Although mobile populations in transit who endure such conditions have high need for mental health prevention, few evidence-based interventions are tailored to women in transit. Moreover, while women and children’s mental health are interconnected, few mental health interventions address parenting needs. We propose to adapt ‘Mamá Empoderada’ [Mom Power] - a theory-based, trauma-informed group intervention to promote mental health and positive parenting among mothers with young children (0-5 years) for the first time with MMC. This multi-component intervention includes a parenting program alongside activities to address connection to resources and social support. It has demonstrated efficacy on reduced parenting stress and mental health symptoms for trauma-exposed U.S. mothers and has recently been translated into Spanish. Our specific aims are to 1) Adapt, pre-test, and refine ‘Mamá Empoderada’ with MMC; 2) Conduct a pilot study of the adapted intervention to determine acceptability and estimate effect sizes on symptoms of depression, anxiety, and parenting stress; and 3) Explore which theory-based mechanisms of action predict changes in symptoms of depression, anxiety, and parenting stress, and identify factors associated with differential intervention response. We will conduct focus groups and pre-testing to adapt and refine the intervention, and conduct a pilot RCT of the adapted intervention with MMC (N=100; Ntreatment=50; Ncontrol=50). The intervention group (IG) will receive trauma-informed group and individual sessions on parenting, linkage to resources (e.g., food, shelter), social support, and resilience. The control group will receive written intervention materials, standard of care programming, and participate in the intervention following completion of the study by the IG (i.e., after 6 months). Both groups will complete baseline and exit surveys, as well as follow-up surveys at 3- and 6- months post-intervention. Amid rising population displacement and prolonged and traumatic journeys, this study addresses an urgent need for scalable and tailored mental health prevention for MMC in transit.

Key facts

NIH application ID
10730411
Project number
1R34MH134047-01
Recipient
SAN DIEGO STATE UNIVERSITY
Principal Investigator
IETZA BOJORQUEZ
Activity code
R34
Funding institute
NIH
Fiscal year
2023
Award amount
$615,668
Award type
1
Project period
2023-08-16 → 2026-08-15