Improving Perinatal Mental Health among Latinas through a Culturally Adapted, Multi-Level Intervention

American University, Washington DC

Investigators

Abstract

ABSTRACT Summary: Maternal morbidity and mortality are at an all-time high in Texas, particularly among Latina women. One major contributor to this public health crisis is under-treated mental health conditions. The purpose of this Career Development Award is to provide Dr. Petruzzi with the training, career development, and mentorship necessary to improve maternal mental health outcomes among Latina women through a culturally-adapted, intervention that simultaneously addresses mental health and social needs. Candidate: Dr. Petruzzi is a health equity researcher and a research associate in the Division of Community Engagement and Health Equity at the Department of Population Health of Dell Medical School. She is a clinical social worker and has over a decade of research experience in hospital and healthcare settings. While she has expertise in mental health and social needs, her career will be propelled by acquisition of skills in intervention development, cultural adaptation, and clinical trial design. Mentorship: Mentors are nationally recognized investigators with complementary expertise: Dr. Carmen Valdez (Latina maternal mental health), Dr. Deborah Parra-Medina (intervention development and cultural adaptation) and Dr. Emily Miller (perinatal mental health and clinical trials). Several advisors will support this proposal, including an expert in problem solving therapy (Dr. Sampson), an expert in perinatal patient navigation (Dr. Yee) and a biostatistician (Dr. Hobbs). Training: Dr. Petruzzi will receive both didactic and experiential training in community intervention development, cultural adaptation, and hybrid effectiveness implementation clinical trial design through coursework, workshops, meetings with mentors and advisors, conferences, and manuscript writing. Research: Maternal mortality is at an all-time high in Texas, particularly among Latina women. Mental health risk factors such as depression and suicidality have been identified as the leading cause of maternal mortality. Evidence based interventions such as patient navigation and problem-solving therapy have been developed to improve maternal health outcomes among racial and ethnic minorities. However, few interventions address both mental health and social needs, and even fewer are culturally or linguistically adapted, which could improve feasibility and acceptability among Latina women. This proposal is innovative in combining two evidence-based interventions (problem-solving therapy and patient navigation) to improve perinatal mental health among Latinas. The specific aims are: 1) conduct a community assessment to identify the culturally relevant mental health and social needs of pregnant/postpartum Latina women in Central Texas; 2) combine, culturally and linguistically adapt two evidence-based interventions (problem-solving therapy and patient navigation) for pregnant Latina women to simultaneously address mental health and social needs; and 3) conduct a feasibility study to assess acceptability and feasibility of the intervention. Preliminary data from the feasibility study will inform a R01 hybrid effectiveness implementation clinical trial to generate the necessary evidence to improve rates of maternal mortality among Latina women.