MomNet: Development of a Coach-Training Program for an Empirically Supported, Guided ehealth Intervention for Depressed Mothers

Project Summary/Abstract Economically disadvantaged mothers of young children experience disproportionately high rates of depressive symptoms, yet often do not receive treatment due to instrumental and psychological barriers. Remission of maternal depression relates to improvements in both parenting behavior and child functioning, suggesting that treatment of maternal depression has the potential to improve outcomes across generations. To increase access to evidence-based depression treatment in this population, we developed Mom-Net, a coach-guided, e-health intervention for depressed mothers of young children. Mom-Net is coach-guided, given evidence that guided interventions produce significantly higher levels of engagement and effectiveness than unguided interventions. Mom-Net has demonstrated effectiveness in two controlled trials with low-income depressed mothers, with effectiveness derived from in-person coach training by a professional Mom-Net trainer. To increase Mom-Net dissemination, our Phase I SBIR efforts focused on developing and evaluating remote coach-training prototypes for paraprofessionals, replicating the in-person training program. Remote coach training includes self-guided online sessions, webinar live practice sessions with a professional trainer, and a certification process. At the end of Phase I, we received funding for a Mom-Net hybrid, type II implementation-effectiveness study (R01MH120237), resulting in quick expansion of the Phase 1 prototypes into a completed remote training process as a necessary component of the trial. The current Phase II project builds upon the R01 effort and a positive evaluation and successful realization of Phase I project goals. Phase II aims to: 1) create a remote Train- the-Trainer program and Administrative Portal, allowing community settings to internally train and monitor their own staff; 2) evaluate the Train-the-Trainer program on the primary outcomes of session completion, Mom-Net content and coaching skills knowledge, teaching strategy knowledge, and fidelity in observed trainer use of teaching strategies; 3) examine effectiveness equivalence between the two Mom-Net coach training options in a randomized trial in 33 Head Start agencies. Four staff within each agency (n = 132) will serve as paraprofessional coach trainees, randomized to be trained by either the external professional coach trainer or the trainer within the agency. Equivalency will be evaluated on session completion, Mom-Net content mastery, and fidelity in coaching skills. The proposed project, culminating in training at scale by offering two training options, will enable commercialization and broader dissemination of Mom-Net which, in turn, will contribute to greater access to a vulnerable, underserved population of mothers experiencing depressive symptoms.