Preventing Perinatal Depression in African American Adolescents Open Access
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Poor, adolescent, racial/ethnic minority women are at great risk for developing perinatal depression. Furthermore, perinatal depression is associated with negative outcomes in both mothers and their babies. Unfortunately, little research has been conducted on the prevention or treatment of perinatal depression in adolescents. This bundled dissertation consists of two papers and addresses this significant research and clinical gap. The first paper is a literature review of existing interventions that target perinatal depression in adolescents. This paper highlights the dearth of research-based options that exist for preventing or treating perinatal depression in adolescents, and examines the few interventions that have been shown to be efficacious with this population. This paper has been published in The Journal of Adolescence (Lieberman, Le, & Perry, 2014). The second paper (which has been written but not yet submitted for publication) documents the cultural adaptation of an intervention designed to prevent perinatal depression in African American adolescents in Washington, D.C. Specifically, it describes the application of Barrera and Castro’s (2006) “Heuristic Framework for the Cultural Adaptation of Interventions” to an empirically-based intervention, the Mothers and Babies Course, in order to fit the context of African American adolescents. The paper follows four steps outlined by the Heuristic Model: 1) information gathering (via literature review and qualitative investigation); 2) preliminary adaptation of the intervention based on information obtained in Step 1; 3) preliminary tests of the intervention; and 4) adaptation refinements based on lessons learned in the third step. The pre-post pilot test of the adapted intervention (the Mothers and Babies Course- Adolescent Version) was conducted with a sample of 29 African American, low-income perinatal adolescents in aa program for pregnant and parenting students in Washington, D.C. Public Schools. Quantitative results provided preliminary evidence for the effectiveness of the MBC-A: participants had significantly lower depressive symptom scores after the intervention, compared with their pre-intervention scores. Qualitative results provided evidence for intervention feasibility and acceptability. Thus, participants reported being more satisfied than not with the intervention, especially with regard to: the integration of technology to demonstrate core concepts; content related to interpersonal relationships; and the ability to share with and be supported by their peers. These two papers advance the field of research regarding interventions for perinatal depression in low-income African American adolescents. The papers highlight the importance of taking culture, developmental stage, and context into account when adapting or implementing interventions. More generally, the work also speaks to the broader goal of eliminating health and mental health disparities based on race, ethnicity, and socioeconomic status.