Leveraging a public-public partnership in Los Angeles County to address COVID-19 for children, youth, and families in underresourced communities.

There is growing concern about the mental health and social impact of COVID-19 on underresourced children, youth, and families given widespread social disruption, school closures, economic impact, and loss of lives. In this commentary we describe how an existing public-public partnership between a large county mental health department and a state university responded to COVID-19. This partnership, originally designed to address workforce needs, rapidly pivoted to support providers through a trauma- and resilience-informed approach to mitigating adverse mental health effects among youth and families in Los Angeles County. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Promoting Behavioral Health Equity Through Implementation of the Incredible Years Within Primary Care.

Mental health disparities continue to be a concern for racial and ethnic minorities in the United States. Further, approximately 20% of children in the United States have a mental health disorder with less than half of these youth receiving mental health treatment (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015; Stancin & Perrin, 2014; U.S. Surgeon General, 1999). Integrated primary care has been identified as an ideal place where youth and families can receive mental health services. There is evidence supporting that when psychologists are in primary care, behavioral health outcomes improve and the costs per patient are reduced (Chiles, Lambert, & Hatch, 1999). The objective of this paper is to describe the steps taken to colocate The Incredible Years Parenting Program (IY; Webster-Stratton & Reid, 2010) an evidence-based parenting group, in a pediatric primary care setting at a major metropolitan children's hospital. The parenting group was delivered as a prevention and early intervention program for an underserved population, specifically focused on parents of children ages 3-6 years, to reduce health disparities and improve access to needed behavioral health care. A case study illustrates the potential benefits to mental health and physical health outcomes through colocation, and ultimately integration, of behavioral health services in primary care. Policy implications for sustainability of group parenting interventions in primary care, the impact on decreasing health disparities, and future directions along this line of research are discussed.

Responding to women's needs and preferences in an online program to prevent postpartum depression.

PURPOSE: Global access to adequate resources to address postpartum depression (PPD) are limited and, at times, not reflective of the needs of pregnant women and new mothers. Gathering information about the preferences and needs of women when designing and implementing Internet-based programs is warranted, especially given the diversity of experiences related to childbirth. Thus, the aim of this study was to obtain user feedback on the content, structural, and cultural factors associated with a fully automated online PPD prevention intervention that, like similar programs, suffered from poor adherence and engagement. METHODS: Following the completion of the Mothers and Babies Internet Course (eMB), an online prevention of PPD trial, a convenience sampling method was used to invite consenting participants to return to the site. Participants provided anonymous feedback on how to improve and adapt the eMB based on screenshots and video content from the Internet intervention. Demographic information and engagement in the online trial were examined as factors influencing participant responses. RESULTS: One hundred nineteen English and Spanish speaking women from 27 countries and territories provided feedback about the eMB. Content-based feedback included requesting additional detail in explanations and simplifying recommended exercises. Structure-based feedback included requests for more visual representations of the materials. In general, participants did not explicitly suggest culturally specific feedback that differed by geographic region, but instead reported similar themes related to motherhood and childrearing. An unexpected finding that only emerged among English-speaking participants was the need for the eMB to address perfectionism and introspection as factors that impact motherhood. Relative to those who did not access the eMB in the parent study, women who did thought the intervention content was acceptable (i.e., no suggested changes) and provided feedback that referenced maternal stress and pregnancy experiences. Age, education, pregnancy status and number of children were not significant factors associated with participants' use of the eMB. CONCLUSIONS: Findings from this study offer preliminary information about the needs and preferences of an international sample of childrearing women who access automated Internet interventions to manage mood changes during the perinatal period.

A proof-of-concept pilot randomized comparative trial of brief Internet-based compassionate mind training and cognitive-behavioral therapy for perinatal and intending to become pregnant women.

OBJECTIVE: Depression is a prevalent and costly mental health problem that affects women as well as their larger communities, with substantial impacts on mother and infant during childbearing years. Face-to-face care has not adequately addressed this global concern due to difficulties in scaling these resources. Internet interventions, which can provide psychological tools to those lacking adequate access, show promise in filling this void. METHOD: We conducted a 2-condition proof-of-concept pilot randomized trial comparing brief Internet-based cognitive behavioural therapy (CBT) and brief Internet-based compassionate mind training (CMT) for women who are currently pregnant, became pregnant within the last year, and intend to become pregnant in the future. RESULTS: We found that, although CMT and CBT demonstrated near equivalence in improving affect, self-reassurance, self-criticism, and self-compassion, CMT showed superiority to CBT in reducing depression and anxiety symptoms. CONCLUSION: These findings provide a compelling initial argument for the use of CMT as an avenue for addressing problems associated with negative affect. Implications, limitations, and future directions along this line of research will also be discussed.

Comparing Brief Internet-Based Compassionate Mind Training and Cognitive Behavioral Therapy for Perinatal Women: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Depression that occurs during the perinatal period has substantial costs for both the mother and her baby. Since in-person care often falls short of meeting the global need of perinatal women, Internet interventions may function as an alternate to help women who currently lack adequate access to face-to-face psychological resources. However, at present there are insufficient empirically supported Internet-based resources for perinatal women. OBJECTIVE: The aim of this study is to compare the relative efficacy of Internet-based cognitive behavioral therapy (CBT) to a novel Internet-based compassionate mind training approach (CMT) across measures of affect, self-reassurance, self-criticizing, self-attacking, self-compassion, depression, and anxiety. While CBT has been tested and has some support as an Internet tool for perinatal women, this is the first trial to look at CMT for perinatal women over the Internet. METHODS: Participants were recruited through Amazon Mechanical Turk (MTurk) and professional networks. Following completion of demographic items, participants were randomly assigned to either the CBT or CMT condition. Each condition consisted of 45-minute interactive didactic and follow-up exercises to be completed over the course of two weeks. RESULTS: Post course data was gathered at two weeks. A 2x2 repeated measures analysis of variance will be conducted to analyze differences between conditions at post course. CONCLUSIONS: The implications of the trial will be discussed as well as the strengths and limitations of MTurk as a tool for recruitment. We will also briefly introduce the future directions along this same line of research. TRIAL REGISTRATION: ClinicalTrials.gov NCT02469324; https://clinicaltrials.gov/ct2/show/NCT02469324 (Archived by WebCite at http://www.webcitation.org/6fkSG3yuW).

Keywords to recruit Spanish- and English-speaking participants: evidence from an online postpartum depression randomized controlled trial.

BACKGROUND: One of the advantages of Internet-based research is the ability to efficiently recruit large, diverse samples of international participants. Currently, there is a dearth of information on the behind-the-scenes process to setting up successful online recruitment tools. OBJECTIVE: The objective of the study was to examine the comparative impact of Spanish- and English-language keywords for a Google AdWords campaign to recruit pregnant women to an Internet intervention and to describe the characteristics of those who enrolled in the trial. METHODS: Spanish- and English-language Google AdWords campaigns were created to advertise and recruit pregnant women to a Web-based randomized controlled trial for the prevention of postpartum depression, the Mothers and Babies/Mamás y Bebés Internet Project. Search engine users who clicked on the ads in response to keyword queries (eg, pregnancy, depression and pregnancy) were directed to the fully automated study website. Data on the performance of keywords associated with each Google ad reflect Web user queries from February 2009 to June 2012. Demographic information, self-reported depression symptom scores, major depressive episode status, and Internet use data were collected from enrolled participants before randomization in the intervention study. RESULTS: The Google ads received high exposure (12,983,196 impressions) and interest (176,295 clicks) from a global sample of Web users; 6745 pregnant women consented to participate and 2575 completed enrollment in the intervention study. Keywords that were descriptive of pregnancy and distress or pregnancy and health resulted in higher consent and enrollment rates (i.e., high-performing ads). In both languages, broad keywords (eg, pregnancy) had the highest exposure, more consented participants, and greatest cost per consent (up to US $25.77 per consent). The online ads recruited a predominantly Spanish-speaking sample from Latin America of Mestizo racial identity. The English-speaking sample was also diverse with most participants residing in regions of Asia and Africa. Spanish-speaking participants were significantly more likely to be of Latino ethnic background, not married, completed fewer years of formal education, and were more likely to have accessed the Internet for depression information (P<.001). CONCLUSIONS: The Internet is an effective method for reaching an international sample of pregnant women interested in online interventions to manage changes in their mood during the perinatal period. To increase efficiency, Internet advertisements need to be monitored and tailored to reflect the target population's conceptualization of health issues being studied. TRIAL REGISTRATION: ClinicalTrials.gov NCT00816725; http://clinicaltrials.gov/show/NCT00816725 (Archived by WebCite at http://www.webcitation.org/6LumonjZP).