Development and Evaluation of the Heart2Heart Psychological Intervention for Pregnant Individuals Carrying a Fetus Diagnosed with Congenital Heart Disease

Congenital heart disease (CHD) refers to a broad range of heart defects present since birth and commonly identified in utero, often requiring neonatal heart surgery shortly after birth. CHDs are a leading cause of death in the United States (Oster et al., 2013), and pregnant individuals carrying a fetus with CHD exhibit greater symptoms of stress, anxiety, trauma, and depression compared to pregnant individuals without a fetal CHD diagnosis (Woolf-King et al., 2017; Wu et al., 2020). Although existing evidence-based prenatal psychological interventions have effectively reduced or prevented maternal distress (O’Connor et al., 2019), none are targeted toward pregnant individuals with a prenatal diagnosis of fetal CHD (Kasparian et al., 2019). The purpose of this two-part study is to develop a new psychological intervention, Heart2Heart, to prevent and reduce distress in individuals carrying fetuses with CHD and to evaluate the intervention’s preliminary effectiveness, acceptability, feasibility, and potential for translatability using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework (Glasgow et al., 2019). In the first part of this study, an existing evidence-based intervention was adapted to create the Heart2Heart intervention using Chu and Leino’s (2017) Cultural Adaptation Treatment Framework (CTAF). In the second part of this study, the Heart2Heart intervention was pilot tested in a large urban children’s hospital (n=12; Phase 1). A mixed-methods study was then conducted with individuals who did and did not participate in treatment as well as medical and research staff to inform a comprehensive intervention evaluation (Phase 2). Results of the evaluation suggest the Heart2Heart intervention was highly acceptable, had a strong potential for translatability, and had an impact on subjective distress among pregnant individuals carrying a fetus with CHD. Findings from the RE-AIM evaluation can inform future systematic adaptations of the intervention, including more postpartum support, greater integration within the medical system, and improved fidelity to homework via mobile technology. Future research should focus on rigorous study designs, such as randomized controlled trials, in larger samples to test the efficacy and effectiveness of the intervention. The novel Heart2Heart intervention represents a major contribution to the mental health care needs of pregnant individuals carrying a fetus with CHD by providing individualized and evidence-based psychosocial support.

Author

• Julian, Melissa

Language

• en

Date created

• 2023

Type of Work

• Dissertation

License

• All rights reserved

Rights statement

• In Copyright

GW Unit

• Clinical Psychology

Degree

• Ph.D.

Advisor

• Le, Huynh-Nhu

Committee Member(s)

• Limperopolous, Catherine
• Howe, George

Persistent URL

•  https://scholarspace.library.gwu.edu/etd/0z708x203