Times are displayed in (UTC-05:00) Central Time (US & Canada) Change
About this paper symposium
| Panel information |
|---|
| Panel 16. Prevention and Interventions |
| Paper #1 | |
|---|---|
| Pilot Implementation of Mom Power in the Appalachian Highlands | |
| Author information | Role |
| Dr. Diana Morelen, Ph.D., East Tennessee State University, Department of Psychology; Association of Infant Mental Health in Tennessee, United States | Presenting author |
| Megan Wolff, East Tennessee State University, Department of Psychology, U.S.A. | Non-presenting author |
| Kelly Daneil, East Tennessee State University, Department of Psychology, U.S.A. | Non-presenting author |
| Rachel Meg Clingensmith, East Tennessee State University, Department of Family Medicine, U.S.A. | Non-presenting author |
| Julia Najm, Dartmouth Hitchcock Medical Center, U.S.A. | Non-presenting author |
| Vinaya Thomas, East Tennessee State University, Department of Psychology, U.S.A. | Non-presenting author |
| Rebecca Otwell-Dove, State of Franklin Health Care Associates; Kingsport Pediatrics, U.S.A. | Non-presenting author |
| Robyn Dolson, Northwest Anxiety Institute, U.S.A. | Non-presenting author |
| Abstract | |
|
Introduction: Children need safe, stable, and nurturing relationships with a caregiver for optimal development. Maternal childhood adversity, traumatic life experiences, and mental health challenges can adversely impact parenting beliefs and behaviors in ways that compromise a caregiver’s ability to create and sustain a healthy caregiving environment for their child(ren) (Goodman, 2019; Morelen et al., 2018; Rosenblum et al., 2017). In the professional world of infant and early childhood mental health (IECMH), policies, providers, and programs work together to promote optimal child and family wellbeing to reduce the intergenerational transmission of risk and to empower resilience in families and communities (Boparai et al., 2018; Rosenblum et al., 2017). Present Study: The present study investigated the feasibility and effectiveness of the pilot implementation of an evidence-based IECMH program, Mom Power, in the Appalachian Highlands (rural northeast Tennessee and Southwest Virginia) as all previously published Mom Power research has been conducted in more urban regions. Mom Power is a ten-session attachment-based parenting and self-care skills group for mothers with high psychosocial risk and their young children (Rosenblum et al., 2017). Methods: Participants included 78 mothers from the Appalachian Highlands who were recruited from primary care settings and community agencies that serve families with high psychosocial need. Most participants identified as White (84.6%), and ages ranged from 18 to 53 years. See Table 2 for a list of study measures. Of note, several measures were changed early in the study protocol in order to better coordinate with ongoing Mom Power research happening across the U.S. Results: Results indicated this implementation of Mom Power recruited and successfully engaged mothers with high psychosocial needs, indicated by a greater percentage of participants who experienced at least one ACE, experienced anxiety and/or depressive symptoms in the past two weeks, met the cutoff for PTSD, fell below the federal poverty guideline, were unemployed or stay-at-home mothers, and had Child Protection Services involvement compared to U.S. adult women (see Table 1). Half of our sample were mothers in recovery, primarily from opioid use or multi-substance use. Of the 78 participants initially recruited, 93.6% (n = 73) attended the first group session. Of those, 61.5% (n = 48) had high attendance (attended seven or more sessions), and those with low/moderate attendance (attended six or fewer sessions) attended on average three sessions. Additionally, involvement with this implementation of Mom Power overall resulted in significant increases in psychological wellbeing, environmental wellbeing, observable maternal emotion regulation, feeling comfortable asking for help, and feeling connected to community professionals, as well as significant decreases in perceived stress, difficulties with emotion regulation, and feeling isolated from pre-assessment to post-assessment for each participant. Discussion: The findings confirm the feasibility of conducting Mom Power in the Appalachian Highlands and offer insight that Mom Power is effective at strengthening protective factors and promoting resilience, even if participants do not have perfect attendance. Additional unique cultural considerations of adapting Mom Power to serve rural Appalachia with high rates of ACEs and substance misuse will also be discussed. |
|
| Paper #2 | |
|---|---|
| Virtual Mom Power for Mothers with High Adverse Childhood Experiences: Preliminary Results from a RCT | |
| Author information | Role |
| Sarah Gray, University of Connecticut, United States | Presenting author |
| Hilary Skov, Department of Psychological Sciences University of Connecticut, U.S.A. | Non-presenting author |
| Renee Lamoreau, Department of Psychology, Tulane University, U.S.A. | Non-presenting author |
| Alison Pequet, Department of Psychology, Tulane University, U.S.A. | Non-presenting author |
| Victoria Parker, Department of Psychology, University of Toronto, Canada | Non-presenting author |
| Stacy Drury, Child Psychiatry, Harvard Medical School / Children’s Hospital Boston, U.S.A. | Non-presenting author |
| Abstract | |
|
Preventive interventions are particularly needed for families disproportionately and chronically exposed to stressors (e.g., poverty, violence) because these exposures increase risk for psychological and relational outcomes that can disrupt sensitive parenting behaviors and impact parent-child relationships. We report on pre-post preliminary data from a randomized controlled trial of virtual Mom Power (vMP) – an attachment-focused, group-based intervention for mothers and young children. We hypothesized that families randomized to treatment would see improvements in maternal mental health and emotion dysregulation and reductions in child and family risk factors. Consistent with previous MP studies, we hypothesized that treatment would be differentially effective among mothers who experienced trauma exposure. Methods. Mothers and their children (3-5 years; n=43 dyads; 54.5% girls; primarily African American) were recruited from local service providers. All families were within 130% of the poverty level. Participants completed intake home visits and were randomized to receive 1) vMP (10 group + 3 individual sessions) or 2) a weekly information mailer with vMP content, stratified by child age and behavior problems. Twenty-one mothers were randomized to treatment and 22 to the informational control. The primary outcome was maternal depressive symptoms (PHQ-9). Additional outcomes included maternal emotion dysregulation and posttraumatic stress, child emotion regulation/social competence, family resilience, and observed sensitive parenting. All dyads had complete data at intake; four treatment and 5 control dyads were missing post-data, addressed via multiple imputation. Results. Twenty-seven percent of mothers endorsed 4+ Adverse Childhood Experiences (ACEs) at intake and were classified as “high ACEs”; seven of these mothers were randomized to control and 5 to treatment. At intake, mothers with histories of high ACEs reported significantly higher depressive symptoms and emotion dysregulation, as well as significantly lower emotion regulation/social competence in their children and lower family resilience. There were no group differences by ACE status on maternal posttraumatic stress, children’s internalizing/externalizing behaviors, or parenting sensitivity at intake. Randomization was successful; no pre-treatment group differences were observed on outcomes. We conducted intent-to-treat linear mixed models, nested within person and within round of assessment to account for shared variance, examining main and interactive effects of time, randomization, and maternal ACE status. We observed significant ACE-by-time-by-treatment effects for maternal depressive symptoms, emotion dysregulation and family resilience; patterns suggested that vMP was most effective for mothers with histories of early adversity. For parenting sensitivity, there was a time-by-treatment effect, with mothers randomized to treatment demonstrating more change pre-post than control mothers; this effect was not contingent on ACEs. No effects were observed for maternal PTS or child internalizing or externalizing behavior. Discussion. vMP was adapted to engage families who face significant practical and psychological barriers to treatment access and engagement. Data suggest that vMP was specifically effective for shifting maternal depressive symptoms, emotion dysregulation, and family resilience among mothers with histories of early adversity; the intervention also shifted sensitive parenting, regardless of early adversity. Results align with previous research suggesting that Mom Power has the potential to strengthen attachment-focused parenting behavior, maternal mental health, and family-level regulatory processes in high-risk families. |
|
| Paper #3 | |
|---|---|
| Mom Power Intervention Effects on Mental Health and Parenting in Mothers with Opioid Use Disorder | |
| Author information | Role |
| Katherine L. Rosenblum, Ph.D., Department of Psychiatry, Pediatrics and Obstetrics & Gynecology, Michigan Medicine, United States | Presenting author |
| Maria Muzik, Department of Psychiatry, Pediatrics and Obstetrics & Gynecology, Michigan Medicine, U.S.A. | Non-presenting author |
| James Swain, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Shaun Ho, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Kristin Bernard, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| David Garry, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Behzad Sorouri Khorashad, Department of Psychiatry, Michigan Medicine and Department fo Psychiatry, University of Utah, U.S.A. | Non-presenting author |
| Yanni Liu, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Nicole Miller, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Brady Douglas Nelson, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Kaitlyn Reimer, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Richard Rosenthal, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Diana Saum, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Joseph Shwartz, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Noor Shahjamal, Department of Psychiatry and Behavioral Heath, Stony Brook University, U.S.A. | Non-presenting author |
| Abstract | |
|
Introduction: Opioid use disorder (OUD) and perinatal mood and anxiety disorders (PMADs) have been postulated to alter maternal brain neurocircuitry (MBN), which in turn, may underlie less sensitive caregiving. In non-OUD mothers affected by early life adversity, the Mom Power (MP) intervention has been proven to enhance MBN and sensitive caregiving via reductions in maternal postpartum depression, PTSD and parenting stress. We will present results from a clinical trial (NIDA R61) exploring the effects of MP on MBN and caregiving in postpartum mothers with OUD. Hypotheses: OUD- mothers who undergo the MP intervention (vs those who do not) will show pre-to post-reductions in PMDAs and parenting stress and changes to MBN relevant to mood improvements. Study population: Pregnant and postpartum persons with OUD receiving specialized prenatal/birthing and postpartum care in OB at Michigan Medicine (MM) are invited to enroll. Methods: All pregnant/ postpartum persons with OUD who present to MM OB for prenatal, labor or postpartum care, are invited to participate in this single arm pilot. Women who decline participation continue high-frequency routine care with the clinical service; those who agree to participation are invited to join the virtual, once weekly 13-session evidence-based parenting and mental health group therapy, MP (we provide wifi and tablet). Participants fill out pre/post self ratings on 3-item Opiate Craving Scale (OCS), Edinburgh Postpartum Depression Scale, Post-Traumatic Stress Disorder Checklist and Parenting Stress Index (PSI) as proxy for caregiving behaviors. In addition, participants provide pre/post neuroimaging tapping into MBN; neuroimaging includes event-related potentials (ERP) to standardized photos of Crying, Laughing and Neutral unknown children; and functional magnetic resonance imaging (fMRI) “joining” vs. “observing” emotional photos of own vs. unknown child. Results: At present we have preliminary data on 11 mothers with OUD who received MP. At the time of the symposium, we will have a sample size of 25. Post- vs. Pre-MP, participants showed: reduced depressive (t = -2.749, p = 0.021), and PTSD symptoms (t = -2.330, p = 0.042), and reduced PSI parental distress (t = -3.723, p = 0.005). ERP N170 responses were reduced for Crying vs. Neutral faces (t = 2.892, p = 0.018); and fMRI responses that relate to empathic attunement were enhanced for Join vs. Observe own vs. other child's joyful vs. distressed face in MBN = hypothalamus (z = 3.67, p < 0.001) & bilateral amygdala (right, z = 2.56, p = 0.005; left, z = 2.46, p = 0.007). Finally, reduction in OCS correlated with concomitant: reductions in depression (r = 0.748, p = 0.008) and increased late positive potentials (ERP) to Laughing vs. Neutral (r = -0.720, p = 0.019) & Laughing vs. Crying faces (r = -0.808, p = 0.005). Conclusion: For mothers with OUD, MP improves indices of mental health while concurrently enhancing brain responses to child stimuli in the MBN. This is a promising model to study the effects of adversity such as OUD and potential benefits of interventions like MP for optimized maternal mood and parenting sensitivity in mothers with OUD. |
|
| Paper #4 | |
|---|---|
| Connecting with My People: Strong Roots Parent Cafés Address the Parenting Stress and Loneliness Epidemic | |
| Author information | Role |
| Barb Duran, Department of Psychiatry, Michigan Medicine, U.S.A. | Presenting author |
| Katherine Rosenblum, Department of Psychiatry, Pediatrics and Obstetrics & Gynecology, Michigan Medicine, U.S.A. | Non-presenting author |
| Angela Johnson, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Stacy Morris, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Diana Saum, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Emily Alfafara, Department of Psychiatry, Michigan Medicine, U.S.A. | Non-presenting author |
| Maria Muzik, Department of Psychiatry, Pediatrics and Obstetrics & Gynecology, Michigan Medicine, U.S.A. | Non-presenting author |
| Abstract | |
|
Introduction. The U.S. Surgeon General has called for action to address the epidemic of parenting stress and loneliness. Social support is critical for resilience, especially for parents facing caregiving demands. Yet systemic barriers, such as a lack of spaces for meaningful connection, hinder social support. As a result, 56% of families with young children report feeling lonely, and almost half report high stress. Community-based, peer-led parent cafés offer a scalable solution by bringing parents together for meaningful conversations. Although cafés are widely implemented, they have limited empirical support. This proof-of-concept study assesses the newly developed Strong Roots Parent Café (SRPC), which offers parents of young children a forum to discuss their experiences. Grounded in the core concepts of Mom Power, SRPCs aim to strengthen protective factors and reduce loneliness and stress. As a peer-led program, SRPCs are designed to be culturally embedded and community-driven. This evaluation tested the feasibility, acceptability, and perceived efficacy of SRPCs supported by the school district as a community-wide resource. Hypotheses. We hypothesized that parents would participate and find SRPCs helpful in strengthening key protective factors. Study Population. Parents (N=41) participated in at least one SRPC and were pregnant or had a child <6 years old. Race/ethnicity was reported (n=37) as: African American/Black (27%), White (59%); Other (14%). Most families were Medicaid-eligible. Methods. Fourteen cafés were held in community settings. Surveys completed by parents at the end of each session focused on the 5 Protective Factors (PFs): 1) Connecting with My People (social support), 2) Supporting Feelings (knowledge of parenting/development), 3) Getting Help (connecting to resources), 4) Caring for Myself (resilience/stress coping), and 5) Enjoying with My Child (social-emotional competence). Items were read aloud to mitigate literacy demands. Perceived helpfulness was rated by all participants on a 4-point scale for items assessing each of the 5 PFs at each café (4=strongly agree). Efficacy was also assessed by retrospective pre-post ratings, reflecting perceived change from before to after the cafe, on a 5-point scale (5=strongly agree) for the 2 PFs that were selected as the focus of that session, resulting in variable n’s. Qualitative data were derived from open-ended survey responses and key informant interviews. Data collection is ongoing, with substantially more respondents expected at the time of presentation. Results. Parents reported high levels of perceived helpfulness on all 5 PFs (see Table 1), and pre-post ratings also suggested improvement: Caring for Myself (“I knew ways to care for myself”; pre M=4.06, post M=4.44, p=0.05, n=23]; Connecting with My People. (“I didn’t have anywhere to share my parenting challenges”; pre M= 4.08, post M= 3.54, p=0.12, n=14); and Supporting Feelings (“I felt confident about meeting my child’s emotional needs”; pre M= 4.3, post M = 4.8 post, n=15, p<.05). Qualitative data supported these findings (see Table 2). Discussion. This proof-of-concept study suggests SRCPs are feasible, well-received, and perceived as effective in strengthening PFs. While data collection for this pilot is ongoing, current findings warrant further investigation of cafés as a strategy to address loneliness and parenting stress. |
|
⇦ Back to session
It takes a village: Promoting resilience in families with high psychosocial need through community-based programming
Submission Type
Paper Symposium
Description
| Session Title | It takes a village: Promoting resilience in families with high psychosocial need through community-based programming |