Digital CBT to Address Parental Depression and Enhance Family Well-Being in Low-Income Households with Young Children

PROJECT SUMMARY/ABSTRACT Low-income families with young children represent a group with a disproportional risk for depressive symptomatology, with limited access to mental health services. In two randomized controlled trials, we developed and evaluated Mom-Net, an evidence-based, coach-guided intervention for moderate to high depression, targeting the interplay between maternal depression and parenting difficulties (R01MH091199 & R01MH070426). Mom-Net, in two controlled RCTs, demonstrated effectiveness in improving maternal depression, self-efficacy, child well-being, and parenting satisfaction. Subsequently, a hybrid type 2 implementation-effectiveness study was awarded (R01MH120237), supporting implementation of Mom-Net in community Head Start agencies across the nation. This grant resulted in crucial agency feedback on unaddressed issues, prohibiting large-scale feasibility and dissemination. Two main concerns identified by agencies were the ongoing workforce crisis, which limits resources to be able to work with a guided coach-model, and a need to expand the intervention beyond mothers. To this end, the proposed project is designed to develop and initially evaluate a prototype intervention, “Parenting-Net”, designed to address these pressing community needs. Parenting-Net is an unguided depression intervention for mild to moderate depressive symptoms, based on Mom-Net CBT strategies, and being created to resonate with a broader range of caregiver roles, sex, and races. Parenting-Net will come with a Navigator Connection training tool for agency staff to learn an initial, brief Engagement Call process to motivate and engage caregivers into intervention. Parenting-Net, when offered commercially alongside the guided Mom-Net program, will allow agencies to offer service access to caregivers with a wider range of depressive symptom levels, tailored to resources available at agencies providing services to families with young children. To develop and tailor content, we will conduct: 1) in-depth interviews with 15 Head Start caregivers of varying races, sex, and caregiver roles to inform the expansion of Mom-Net content and parenting contexts within CBT strategy discussions; 2) focus groups with 5 Head Start staff to inform the learning format and context of the Navigator Connection training program. Participants for the feasibility study will include 30 caregivers, recruited by 10 Head Start agency navigators. Outcomes of feasibility, acceptability, and preliminary effectiveness will be assessed, and further feedback will be gained. With this input, programs will be completed, improved, and evaluated via a randomized controlled trial in Phase 2.