ICBT (Internet Based Cognitive Behavioral Therapy) for Maternal Depression: Community Implementation in Head Start

Well-established measure of maternal depression with 9 self-report items, each rated on a 0 (not at all) to 3 (nearly every day) scale; total score will be used; interpretation: scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe,and severe depression, respectively. Total score will be used to examine change from baseline to subsequent assessments.

Implementation Outcome Variable. 14-item scale, rated on a 1-5 response scale. Will examine perceived helpfulness of Mom-Net content, activities, and coach calls. This scale has been used in investigators' prior Mom-Net research. The summed-item total score will be used, with a scale range of 14-70.

Implementation Outcome. Screening rates will be calculated as the number of PHQ-9 screeners administered within each agency each year divided by the family HS enrollment (with a female-identified parent-figure). The metric will represent the percentage of mothers in each agency who were reached, with a range of 0-100.

Implementation Outcome. Calculated as the number of Mom-Net eligible mothers screened within each agency divided by the number of mothers within each agency initiating Mom-Net intervention with a within-agency range of 0-100%.

Number of modules (0-8) and coach calls completed, page views (0-120), and program visits (0- no upper limit). These well-established indices of usage will be collected in real time.

Subscales will all be used to examine change in maternal behavior from baseline through subsequent assessment points; subscale total scores will be used; all items rated on a 0 (I don't do this) to 5 (I often do this) scale and summed for subscale total; Supportive/Engaged sub-scale range 0-55, Hostile/Coercive subscale range 0-45.

Will use will three metrics to assess change in maternal sense of competence from Baseline through subsequent assessments: Total score, 17 items; Efficacy subscale, 8 items, Valuing/Comfort subscale, 9 items; all items are rated on a 1 (Strongly Agree) to 6 (Strongly Disagree) scale. Items will be summed to form: Total score (range of 17-102), Efficacy score (range 4-48) and Valuing/Comfort score (range 9-54). For total and subscale scores, a high score will reflect strong competence.

Well-established measure of child internalizing/externalizing behavior; all items rated on 0 (not true), 1 (somewhat or sometimes true), 2 (very true or often true) scale; Both the Internalizing (36 items) and externalizing (24 items) subscales will be used, with raw score ranges of 0-72 and 0-48, respectively. Raw scores will be used in analysis of the age-associated t-scores.

Well-established measure used to examine change in child internalizing/externalizing behavior; all items rated on 0 (not true), 1(somewhat or sometimes true), 2 (very true or often true) scale; Both the internalizing (32 items) and externalizing (34 items) subscales will be used, with raw score ranges of 0-64 and 0-68, respectively. Will be used in analysis of the t-scores associated with the raw score totals.

The Living in Family Environments (LIFE) and Dyadic Parent-Child Interaction Coding System (DPICS) are two systems for coding family interactions. Investigators are using the LIFE affective codes and the DPICS verbal codes. Though the LIFE has verbal codes, the DPICS verbal codes are more developmentally appropriate. This approach has been used in earlier work. This outcome reflects the proportion of aggressive interpersonal behavior across the duration of the interaction.

The Living in Family Environments (LIFE) and Dyadic Parent-Child Interaction Coding System (DPICS) are two systems for coding family interactions. Investigators are using the LIFE affective codes and the DPICS verbal codes. Though the LIFE has verbal codes, the DPICS verbal codes are more developmentally appropriate. This approach has been used in earlier work. This outcome reflects the duration per episode of aggressive interpersonal behavior observed during the interaction.

The Living in Family Environments (LIFE) and Dyadic Parent-Child Interaction Coding System (DPICS) are two systems for coding family interactions. Investigators are using the LIFE affective codes and the DPICS verbal codes. Though the LIFE has verbal codes, the DPICS verbal codes are more developmentally appropriate. This approach has been used in earlier work. This outcome reflects the proportion of positive interpersonal behavior across the duration of the interaction.

The Living in Family Environments (LIFE) and Dyadic Parent-Child Interaction Coding System (DPICS) are two systems for coding family interactions. Investigators are using the LIFE affective codes and the DPICS verbal codes. Though the LIFE has verbal codes, the DPICS verbal codes are more developmentally appropriate. This approach has been used in earlier work. This outcome reflects the duration per episode of positive interpersonal behavior observed during the interaction.

The Work and Social Adjustment Scale (WSAS) assesses the impact of mental health difficulties on ability to function in the context of work, home management, social leisure, private leisure, and personal or family relationships. Possible scores range from 0 to 40, where lower scores indicate fewer symptoms.

The Well-Being Index is a short self-report measure assessing current wellbeing. Possible scores range from 0 to 25, where higher scores indicate better quality of life.