GMH Newsletter – Preventing Perinatal Depression-June 2023 – UW Consortium for Global Mental Health

Link to full June 2023 Newsletter

A Note from the Director

May was Mental Health Awareness month in the United States. I particularly appreciate the theme that the National Alliance on Mental Illness (NAMI) is promoting this year: #MoreThanEnough. The organization explains the meaning:

“We want every person out there to know that if all you did was wake up today, that’s more than enough. No matter what, you are inherently worthy of more than enough life, love and healing. Showing up, just as you are, for yourself and the people around you is more than enough.”

Keshet Ronan’s Work Preventing Perinatal Depression

We spoke with Keshet Ronan, PhD, MPH, Assistant Professor of Global Health, about a few of their projects on perinatal mental health, below we highlight a completed project that was done in the U.S., adapting methods Dr. Ronan had used previously in Kenya. A key feature of global mental health is the bidirectional translation of innovations in interventions to a new context to meet patient needs.

Tell us about your IMAGINE project.

IMAGINE sought to develop an intervention to prevent perinatal depression among young perinatal people in the US, by adapting an evidence-based in-person intervention for virtual delivery. We adapted an intervention called Mothers and Babies, which is an in-person 6-session intervention that uses principles of cognitive behavioral therapy, attachment theory, and psychoeducation to help manage mood and stress in the context of pregnancy and parenting a baby.

How and when did your project start?

IMAGINE started in 2019 in response to a call for funding from the University of Wisconsin’s Technology & Adolescent Mental Wellness (TAM) initiative. I had worked on use of technology to facilitate peer support among youth living with HIV in Kenya and was excited to translate some lessons from that to young people in the US, and combine it with my work in perinatal populations.

Our work in Kenya showed that peer support can be very important for people who experience marginalization and that peer support can be achieved remotely using technology, so that orientation affected how we conceived of the intervention. Through our work in Kenya we also learned about the value – and feasibility – of engaging people with lived experience on our study team, so one of our study team members was a young person who had become a mother as a teenager and she supported intervention design and outreach.

Where are you now in the project? What’s the next step?

Our TAM project is complete. We completed formative work, in which Participants told us they wanted a flexible intervention structure, so that they could get content asynchronously to fit with their schedules, but also opportunities to build relationships through synchronous interaction. In response to this feedback we incorporated multiple ways to access content: short messages, visual graphics, and pre-recorded videos that could be accessed asynchronously, as well as an optional weekly synchronous video call. Participants also had concerns about privacy, so we ended up choosing a platform (Slack) that wasn’t connected to any other online identities like social media profiles. We completed a small pilot of the intervention, and found it was acceptable. We also received some good feedback about additional ways to optimize it in the future. We’ve submitted a proposal to conduct a pilot randomized trial with these optimizations to the intervention through an NIH R34.

What is the potential impact of your project?

We hope IMAGINE can be a scalable and accessible way that an evidence-based intervention can reach underserved groups to prevent perinatal depression.

Where will the next study take place? Is there potential for this intervention to be applied in other settings?

The R34 we’ve applied for is in Washington State. Maybe one day we’ll adapt this for other contexts! Mothers and Babies was developed for low-income and racial minority women in the US, so we would need to do some more adaptation for other contexts. And right now, the specific technology we used requires a level of internet access that would be exclusionary for the most at-risk women in low and middle income countries.

Global Mental Health Fellowship Recipients

Each year UW Consortium for Global Mental Health awards travel fellowships for research in global mental health. This year we have awarded three fellowships to MPH Thesis projects. Congratulations Global Mental Health Fellowship recipients, Dr. Marilyn Nyabuti, Dr. Dismas Ouma, and Lauren Gonzalez!

Dr. Marilyn Nyabuti is a medical doctor from Kenya with over 7 years of experience in clinical practice and HIV-related research in low-resource settings. Marilyn has a bachelor’s degree in Medicine and Surgery (MBChB) from the University of Nairobi, Kenya, and is a first-year MPH graduate student in the Department of Global Health at the University of Washington. Marilyn’s project will be evaluating the association between depression and disengagement from HIV care among mothers who have completed prevention of mother-to-child transmission (PMTCT) follow-up in Homabay County, Kenya. In Kenya, PMTCT services are incorporated into maternal and child health (MCH) clinics. This means that women living with HIV oscillate between the MCH and comprehensive care clinics (CCC) multiple times throughout their reproductive age. Evidence from other settings has shown that this period is characterized by a high rate of disengagement from HIV care. Therefore, Marilyn’s project is critical in quantifying the magnitude of the problem and generating scientific evidence that will support the stakeholders in designing interventions that will provide support to mothers during the vulnerable transition period. Marilyn is passionate about mental health as well as maternal and child health and is keen on building a career as a research scientist in the intersection of these fields. Being an early-stage investigator, this project allows Marilyn to hone her research skills as well as build her portfolio in project management, quantitative research, and dissemination of research findings through scientific publications.

Dr. Dismas Congo Ouma (He/Him), likes to go by Congo. He graduated from The University of Nairobi School of Medicine in 2015 with MBChB. Since 2018 he has been a research scientist at Kenya Medical Research Institute (KEMRI), Centre for Microbiology Research (CMR) and currently he is an MPH student in the Department of Global Health at the University of Washington School of Public Health.

Congo received the Global Mental Health travel fellowship for his project “Cross-sectional evaluation of depressive symptoms, sexual risk behavior, and Pre-exposure Prophylaxis (PrEP) adherence among adolescent girls and young women (AGYW) in Western Kenya.” The main goal of this project is to determine the burden of depressive symptoms among a cohort of AGYW and understand the relationships between the presence of depressive symptoms, their recent sexual risk behavior, and PrEP initiation and adherence. His project will be based in Kisumu, Kenya, at KEMRI _CMR research clinical research sites. His team will recruit participants enrolled in the HPV vaccine trial. They will use validated tools to assess the presence of depressive symptoms in this cohort. Congo hopes their findings will provide evidence to support the incorporation of mental health support services into HIV prevention programs. Integrating mental health services into HIV and STI preventive services will address the holistic needs of adolescent girls and other vulnerable groups.

Congo enjoys watching soccer and Formula 1 Racing during his free time. He supports Manchester United football club and Redbull Racing in Formula, and he loves traveling and making new friends.

Laurén Gomez is a second-year MPH student in the Department of Epidemiology and will be entering the PhD program in the Fall. As a Research Coordinator in the Department of Global Health, within the Global Center for Integrated Health of Women, Adolescents and Children (Global WACh), Laurén has supported studies assessing integration of pre-exposure prophylaxis (PrEP) delivery for HIV prevention in maternal and child health (MCH) clinics in Western Kenya. For her thesis, Laurén explored the association of prenatal PrEP exposure and perinatal and infant growth outcomes. Laurén is particularly interested in child neurodevelopment and has previously assessed neurodevelopmental trajectories following antiretroviral therapy (ART) initiation in Kenyan children living with HIV. As part of the Global Mental Health fellowship Laurén will be traveling to Kisumu, Kenya where she will partner with Kenyatta National Hospital to support the implementation of neurodevelopmental assessments nested within safety evaluations of infant ARV exposure (PrEP and dolutegravir (DTG).

The GMH fellowship will allow her to merge her research interests, expand on the work she conducted for her thesis, and would serve as the data collection component of her dissertation. Laurén is committed to building capacity for conducting neurodevelopmental assessments, and fellowship activities include organizing trainings, developing quality control systems, and piloting data collection. Results from these activities will fill evidence gaps on longer-term neurodevelopmental outcomes in the context of growing DTG-ART and PrEP use globally during pregnancy which will inform scale up of PrEP and DTG in Kenya and similar countries.

UW Global Mental Health News

Dr. Krisnamachari Srinivasan Lecture: “We have to ask before we can do anything”— Gender Disadvantage, discrimination, and Common Mental Disorder: Implications for mental health interventions in India. Thursday, June 29, 2023, 3-4pm Pacific Time, University of Washington, Seattle, HRC 101. On Zoom: https://washington.zoom.us/j/94512119376

Lecture: Recording of Dr. Madhuhar Pai’s talk, “Can We Walk Our Talk on Decolonizing Global Health?” for the 2023 Steven Stewart Gloyd Endowed Lecture, at University of Washington.

GMH Students Spotlighted:

GMH Student, Rachel Rinehart is one of 16 UW 100 students in Public Health –UW 100
Read interview with GMH Doctoral Student Tina Mensa-Kwao on partnering with youth to improve their mental health care

Global Mental Health Job and Fellowship Opportunities

Post-Graduate Research Fellowship relevant to Global Mental Health at Stanford

Research Fellowship for MPH or Post Doc at Stanford, 1-4 year appointment, Pay Range: $68,238 – $85,000

Multi-stage study to assess and address mental health needs and barriers to mental health services among the Latinx community in East San José, CA using a community-based participatory research approach with a specific focus on the integration of promotoras (community health workers). Must be fluent in Spanish and English. And because of high level of community involvement, remote work is not possible, fellow must move to/reside in California Bay Area. Job description lists a doctoral degree as a requirement, but they would happily take an MPH!

Postdoctoral Position: Developmental Risk and Cultural Resilience Lab at Brigham and Women’s Hospital, Harvard Medical School

The Developmental Risk and Cultural Resilience Lab (PI: Cindy Liu) at Brigham and Women’s Hospital, Harvard Medical School is looking to hire a postdoctoral fellow to help direct a program of research on maternal and infant/child mental health. The postdoctoral fellow will be responsible for overseeing research activities including data collection and processing, data analysis, and manuscript and grant writing, and the supervision of trainees on a perinatal cohort (PEACE Study). The ideal fellow will have a background within the fields of developmental or clinical psychology, and/or public health, and an interest in perinatal mental health and early childhood development with a track record of publications in these areas. Prior experience with survey and observational data collection of parents and young children, and in particular, behavioral coding and data analysis of longitudinal studies is required. The fellow may assist in other NIH-funded projects within the lab, as well as other projects involving perinatal cohort design. We are looking for someone who shares our lab’s mission in serving underrepresented and underserved minorities through research. The start date for this position is flexible (spring or summer of 2023). This is a full-time position with benefits. It is a one-year position with the possibility for a one-year renewal. Those interested in this position should email a cover letter, CV, and 3 references to Dr. Liu at chliu@bwh.harvard.edu

Tenure-Track Assistant Professor in Population Mental Wellness, School of Public Health at University of Hong Kong

Begins as soon as possible, on a three-year fixed-term basis, with the possibility of renewal subject to satisfactory performance and with consideration for tenure before the expiry of a second three-year fixed-term contract. Requirements: a Ph.D. degree in epidemiology, biostatistics, public health, psychology, behavioral science, cognitive science, or a field related to the study of population mental wellness. A track record of high-quality epidemiologic research on population mental health; demonstrated leadership in building and managing multidisciplinary international collaborative projects; expertise in analyzing large and complex datasets; and competence in mentoring early career researchers and research students.

View link to job description, qualifications, and apply.

Other Global Mental Health Opportunities

Documentary Participation: I HOPE THIS HELPS–Crowd sourced documentary on global mental health, seeking video submissions.

I HOPE THIS HELPS https://ihopethishelpsfilm.com/ is a crowd-sourced global documentary feature film project on people’s personal journeys with mental health. It asks anyone to submit videos to the I HOPE THIS HELPS WEBSITE https://ihopethishelpsfilm.com/. All submissions will be considered and selected submissions will be edited together to create a documentary feature film. There are tips and instructions for filming yourself on the website, including releases https://ihopethishelpsfilm.com/filming-tips

The aim of this project is to make a beautiful film that creates change: by sharing stories that help viewers through their own journey; by destigmatising mental health in society; and by inspiring new research into things that can make a difference. Funded by Wellcome https://wellcome.org/

Upcoming Conferences

2023 Policy Institute: Tweens, Teens, and Technology

Tuesday June 6, 1-5pm Eastern
Registration link
Part of larger Mental Health America Conference, policy institute is FREE
Organized by Mental Health America
In person attendance Washington, D.C.

Save the Date:

2023 Global Mental Health: Research without Borders Conference

Conference homepage link
Conference dates: October 30-Nov 1, Bethesda, MD
Registration Link

Regional Research Symposium: Advancing evidence-based interventions for Mental Health, Child Development, and Parenting

Conference organized by University of Rwanda Centre for Mental Health and the Boston College Research Program on Children and Adversity.
Conference dates: September 20-22, Kingali, Rwanda
Questions: contact event organizers Joseph Kalisa <josephka300@gmail.com> & Libby Evans <evansdw@bc.edu>.