Background

This study is to develop and pilot test a new group-based intervention for depressed Latina mothers of children with asthma. Our ongoing work has identified that close to 50% of Latina mothers of children with asthma report significant symptoms of depression. The intervention will combine asthma education and cognitive-behavioral strategies (e.g., increasing the pleasant activities that you do to help your mood) to address symptoms of depression. We hope to improve mothers’ mood, their feelings of confidence that they can manage asthma, and children’s level of asthma control. The project has two phases.

In Phase 1, we will develop the intervention by working on the treatment manual and then conducting focus groups with Latina mothers to get input on the intervention. We expect 24 mothers at each of 2 sites (Rhode Island and Puerto Rico) to participate in focus groups (8 mothers per group). The group will take approximately 1-1.5 hours.

In Phase 2, we will conduct a small pilot of the intervention at both sites with new participants. At each site, 4 groups (4 sessions each) will be run. Participants will have an equal chance of being placed in the new intervention condition (asthma education and mood management), or in a control condition that covers asthma education and general topics regarding child health and wellness (e.g., encouraging reading, reducing screen time, nutrition). Participants will participate in a baseline research session, in the 4 intervention group sessions, and then in two follow-up research sessions (one at end of treatment, and one 4-months post-treatment). They will complete survey instruments that assess their own depressive symptoms, family demographic characteristics, access/barriers to health care, self-efficacy to manage asthma, social network support, and family climate, as well as their child’s asthma symptom frequency. Children 7-12 are included only for the assessment of asthma symptoms and lung function, which occurs at baseline, end of treatment, and 4-month follow up for 2 weeks at each time point. Participation in Phase 2 is expected to take approximately 6 months.

Findings from the present study will be used to design and implement a larger, randomized, controlled trial of integrated group-based treatment, and to examine treatment effects on asthma outcomes over time.

AIMS

  • Aim 1: The aims of this R21 application are to develop a manualized treatment to integrate asthma education with CBT strategies to reduce depressive symptoms among Latina mothers of children with persistent asthma, thereby reducing asthma morbidity, and to conduct a small two-site pilot of this intervention in Rhode Island and Puerto Rico
  • Aim 2: To test the integrated intervention with depressed mothers of children with asthma (32 in Puerto Rico and 32 in Rhode Island.)

Investigators