Prevention of Maternal Depression across 25 years in the Context of Sociocultural Risk and a Randomized Parenting Intervention

In the United States, there is currently an unprecedented surge in depression rates, particularly affecting low-income women, and especially those who are parents. In part, this surge in depression is due to parenting stress, contextual stressors, and financial strain, and the cumulative impact of these stressful experiences. However, there is a lack of research on maternal depression over long periods of time in low-income samples, which is important because findings from short-term studies of largely higher-income community samples may not extend to other populations. To address this gap, we leverage an existing longitudinal experimental design to prospectively identify variation in trajectories of maternal depression across 25 years in relation to sociodemographic characteristics, child developmental periods, and contextual factors. To capture women’s multiple experiences of stress, we will examine profiles based on contextual risk factors (e.g., neighborhood conditions, social stress, financial strain) and protective factors (e.g., support from family and friends, individual identity, housing stability, neighborhood support) and how they relate to depression trajectories. We will also evaluate whether a family-centered intervention, the Family Check-Up (FCU), might buffer severity in trajectories of depressive symptoms. We will conduct this investigation using the Early Steps Multisite (ESM) Study, a sample of 731 low-income families assessed 13 times from child ages 2 to 19. Families were randomly assigned to the FCU or a control group at baseline. Maternal depression, child/family functioning, and contextual factors have been prospectively assessed for nearly two decades. Families were assessed nearly annually for 8 years post-baseline, and intervention families were offered the FCU. Additional family assessments occurred at 12-, 14-, and 17-year follow-ups (81% retention), and twice in 2021 (18- and 18.5-year follow-ups). For the current project, we plan to re-contact ESM mothers (N = 609; current Mage = 46.90; SD = 6.21) to complete a survey and clinical interview to assess depressive symptoms and disorders, current contextual experiences, and mental/physical health comorbidities. Our overall objective is to extend understanding of long-term patterns of maternal depression in low-income families to inform prevention and intervention approaches that are responsive to various contexts. By identifying social and contextual mechanisms that predict persistence or resilience in maternal depression, we aim to pinpoint contexts in which the FCU might effectively attenuate the risk of enduring maternal depression. Project Number: 1R01MH138582-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: Kit Elam (+4 co-PIs) | Institution: TRUSTEES OF INDIANA UNIVERSITY, BLOOMINGTON, IN | Award Amount: $853,969 | Activity Code: R01 | Study Section: Neurological, Mental and Behavioral Health Study Section[NMBH] View on NIH RePORTER: https://reporter.nih.gov/project-details/11226926