Social Circumstances, Parenting Techniques, and Infant Development
Condition: Postpartum Depression; Infant Development; Rhythm; Sleep
MeSH terms: Depression, Postpartum; Depression
Study type: Interventional

Summary: 
      1. Investigators aim to assess a novel behavioral intervention (currently approved in
           Protocol #6285) behavioral intervention that promotes maternally-mediated behavioral
           changes in young infants to reduce the risk of postpartum depression in a group of low
           income women. More specifically, investigators aim to determine if a behavioral
           intervention targeting maternal caregiving of young infants can increase infant sleep
           and reduce fuss/cry behavior and thereby: (1) reduce the incidence and/or severity of
           postpartum maternal depression in low socioeconomic status (SES) women, and (2) improve
           the quality of mother-infant interaction and subsequent child development. Investigators
           will study:

             1. The feasibility of applying this protocol with a low SES population

             2. The effectiveness of the intervention compared to usual care

             3. If the effects of the intervention can be detected in assessments of the quality of
                mother-infant interaction and infant neurocognitive development

        2. Investigators aim to determine whether this behavioral intervention can affect infant
           development as measured by neurodevelopmental assessments and cortisol reactivity at 4
           months of age.
    

Detailed description: 
      Developmental research consistently shows that postpartum depression has a negative impact on
      cognitive and emotional development during infancy and childhood. Low SES women face unique
      stressors and social challenges. Rates of postpartum depression are significantly higher in
      this group (23-33%) than in the general population (10-15%).

      The purpose of this study is to understand how social circumstances, women's mood, and
      parenting techniques affect infant and child development. Specifically, investigators are
      interested in finding out whether a behavioral intervention, already being administered in
      IRB approved protocol #6285, targeting maternal caregiving of young infants can increase
      infant sleep and reduce fuss/cry behavior, thereby reducing the incidence and/or severity of
      maternal depression and anxiety symptoms, improving the quality of the mother-infant
      interaction, and improving infant developmental outcomes.

      By collecting stress reports from women from low SES backgrounds during pregnancy and the
      postpartum period and by conducting follow-up observational assessments of the quality of
      mother-infant interaction, infant learning, infant cortisol reactivity, and infant
      neurocognitive development, investigators hope to identify whether this intervention can
      effectively meet these aims.
    

Intervention name(s): Resources for Postpartum Parenting
Intervention type(s): Behavioral
Intervention description(s): The intervention includes four-sessions that targets maternal caregiving of young infants to increase infant sleep and reduce fuss/cry behavior and thereby simultaneously consolidate women's enjoyment of and confidence in their maternal role, this, in turn, promotes a cycle of a mutually re- warding engagement in the mother-infant dyad - the antithesis of a 'toxic' experience, and a strong foundation for improving the chances of a successful psychosocial adjustment, including adequate employment. Investigators believe PREPP holds tremendous promise as an intervention to fill the science-practice gap in the promotion of an optimal emotional environment for the developing infant, particularly for women and children living in poverty and/or facing significant psychosocial hardship.
Other intervention name(s): Practical Resources for Effective Postpartum Parenting
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: Depression; Development; Infant sleep