# Prevention of Perinatal Depression in Birthing People with a History of Adverse Childhood Experiences: A Type 2 Effectiveness Implementation Trial

> **NIH NIH R34** · NORTHWESTERN UNIVERSITY · 2024 · $240,000

## Abstract

PROJECT SUMMARY
Prevention of perinatal depression represents an opportunity to optimize maternal and child health outcomes.
However, dissemination and implementation of evidence-based prevention interventions, such as Reach Out,
Stand Strong, Essentials for New Mothers (ROSE), are challenged by the complexity of multidisciplinary
engagement. The collaborative care model (CCM) is an evidence-based health services intervention designed
to integrate mental health care into somatic healthcare contexts and bridge care across medical disciplines.
Accordingly, the CCM represents an ideal and pragmatic infrastructure to support the delivery of ROSE within
obstetric clinics.
Adverse childhood experiences (ACEs) are physical, sexual, and emotional abuses incurred in childhood. A
striking 16% of adults in the United States were exposed to at least 4 ACEs, and the burden of ACEs is
disproportionately borne by historically and socioeconomically excluded populations. Exposure to ACEs is
perniciously associated with somatic and mental health outcomes in adulthood, including perinatal depression.
Perinatal depression, in turn, is associated with adverse outcomes in birthing people and their offspring.
Mitigation of the intergenerational adverse effects of ACEs, via prevention of perinatal depression, is an essential
component of a reproductive justice-focused public health strategy.
Built on the foundations of interpersonal therapy (IPT), ROSE is a pertinent evidence-based approach for low-
income birthing people with a history of ACEs. ROSE's emphasis on the enhancement of support structures may
protect against the impact of ACEs on mental health via overcoming pathogenic beliefs that interfere with healthy
interpersonal functioning. This mechanism is particularly salient during the transition to new parenthood as social
support can decrease the risk of perinatal depression. The infusion of trauma-informed care into the ROSE
intervention, including focused attention on obstetric triggers of trauma and communication of these risks across
the multi-disciplinary health care team, alongside implementation of this intervention within the CCM defines
Trauma-informed ROSE InterventiOn (TRIO).
This project, “Prevention of Perinatal Depression in Birthing People with a History of Adverse Childhood
Experiences: A Type 2 Effectiveness Implementation Trial”, aims, via a hybrid type 2 randomized trial, to evaluate
TRIO, compared to enhanced treatment as usual. Aim 1 will evaluate wither TRIO improves perinatal depression
(both symptom trajectories and dichotomized perinatal depression) among low-income pregnant people with a
history of ACEs. Aim 2 will evaluate mechanisms by which TRIO may improve perinatal depression. Aim 3 will
examine the acceptability, appropriateness, cost, feasibility, and fidelity of TRIO. This proposal will generate key
data to inform the conduct of a full-scale cluster randomized trial of TRIO that will answer the key questions of
how to effective...

## Key facts

- **NIH application ID:** 10929508
- **Project number:** 5R34MH130969-03
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Sheehan David Fisher
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $240,000
- **Award type:** 5
- **Project period:** 2022-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929508

## Citation

> US National Institutes of Health, RePORTER application 10929508, Prevention of Perinatal Depression in Birthing People with a History of Adverse Childhood Experiences: A Type 2 Effectiveness Implementation Trial (5R34MH130969-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10929508. Licensed CC0.

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