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Completed

NCT Number: NCT01298804

Preventing Maternal Depression In Head Start

Maternal depression disproportionately affects low-income and minority women, and has profound negative impacts on their children. The investigators are conducting a randomized trial of a systems approach to identify mothers at risk for depression in Head Start - a federally funded early learning program for children of low-income families - and to provide an on-site intervention to prevent or alleviate depressive symptoms; improve functioning; and, where appropriate, proactively link mothers to more definitive mental health services.

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Key information

Age range

15 year–64 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

ABCD Head Start, Boston, Massachusetts, United States

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About this study

This study is one component of a series of studies that aims to develop a comprehensive system of maternal depression prevention and management within Head Start. In our March 2014 review of the CT.gov protocol, we synchronized it with our institution's IRB protocol, which had been modified based on how the individual studies within this series relate to one another. Specifically, the original IRB protocol combined two studies into one: a 'main' depression prevention trial (n=230, R01MH091871), and a small adjunct pilot aimed at referring those with symptoms of major depression to further care (n=60). Thus, the original CT.gov protocol included subjects both at risk for depression and with symptoms consistent with major depression. When the latter pilot study subsequently received external funding, we separated the two studies into two IRB protocols, and thus have adjusted our CT.gov protocol to the appropriate sample size of 230, and indicated symptoms of major depression as an exclusion criterion for the prevention trial. Because Major Depressive Episode was inadvertently listed as a primary outcome measure for the prevention trial (and PTSD and Anxiety as secondary outcome measures), we have removed them as such and listed it under 'other' outcomes, thereby aligning the CT.gov protocol with the statistical analysis plan of the original grant application and IRB protocol. Lastly, we corrected administrative errors in the study's projected end date and masking design.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Family enrolled in Head Start, and child expected to attend Head Start activities for at least 6 months of the 12-month follow-up period.
  • Family without imminent plans to relocate
  • Mother is comfortable in English or Spanish.
  • Parent/guardian who has a child that attends Head Start
  • Child attending Head Start and is between the ages 0-5
  • Screen positive to 2-question depression screener (PHQ2), or have a past history of depression
  • Ability to provide informed consent.
  • Not suicidal

Exclusion criteria

  • High suicidal ideation
  • Cognitive limitation
  • Psychosis
  • No known risks for depression
  • Symptoms reflecting major depressive episode

Treatment and study plan

Problem Solving Education and Activated Referral to Care

Behavioral

The intervention represents an integrated identification and intervention system based on the evidence-based construct of screening, brief intervention, and referral to treatment (SBIRT). Within the comprehensive case management services of Head Start, eligible women will be randomized to receive either usual care or the Head Start-based intervention. In our intervention, mothers at risk for depression will receive a problem-solving intervention; depression symptom monitoring; and an "Activated" referral to more definitive services for those who have worsening symptoms over time.

Primary outcomes

  1. Depression Symptoms

    Time frame: 2 months

    QIDS

  2. Depression Symptoms

    Time frame: 4 months

    QIDS

  3. Depression Symptoms

    Time frame: 6 months

    QIDS

  4. Depression Symptoms

    Time frame: 8 months

    QIDS

  5. Depression Symptoms

    Time frame: 10 months

    QIDS

  6. Depression Symptoms

    Time frame: 12 months

    QIDS

  7. Problem Solving Skills

    Time frame: 6 months

    Social Problem Solving Inventory

  8. Problem Solving Skills

    Time frame: 12 months

    Social Problem Solving Inventory

Secondary outcomes

  1. Social functioning

    Time frame: 6 months

    Social Adjustment Scale- Self-report

  2. Parent functioning/stress

    Time frame: 6 months

    Parenting Stress Index; Perceived Stress Index

  3. Head Start attendance

    Time frame: 12 months

    Head Start records, analyzed as monthly absence rates

  4. Receipt of Mental Health Services

    Time frame: 12 months

  5. Social functioning

    Time frame: 12 months

    Social Adjustment Scale- Self-report

  6. Parent functioning/stress

    Time frame: 12 months

    Parenting Stress Index, Perceived Stress Index

  7. Child Behavior

    Time frame: 6 months

    Teacher Version of Social Skills Rating System

Other outcomes

  1. Major Depressive Episode

    Time frame: 12 months

    SCID Interview

  2. Post Traumatic Stress Disorder

    Time frame: 12 months

    SCID Interview

  3. Anxiety

    Time frame: 12 months

    SCID Interview

Sponsors and collaborators

Lead sponsor

Boston Medical Center

Other

Collaborators

  • Head Start and Early Head Start Programs in Action for Boston Community Development Incorporated

Registry information

Important dates

Study start
2011
Primary completion
2016
Study completion
2016
First posted
Feb 18, 2011
Registry last updated
Aug 9, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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