123-MOMS: RCT Evaluation of a Three-Phase Intervention on Maternal Mental Health and Child Development to Lay the Foundations for Economic Opportunity and Wellbeing

A key mechanism for the perpetuation of poverty across generations is the accumulated developmental deficits of children from deprived backgrounds, who often lack a nurturing and stimulating environment. Moreover, poverty is associated with an incidence of maternal depression of at least 50%, which, in turn leads to reduced economic opportunities and reduced engagement with children potentially perpetuating poverty intergenerationally. Addressing these effects of poverty on maternal mental health and on child development is an urgent policy matter. We propose to test an intervention delivered virtually via Telehealth  with sequential complementary components: (i) Cognitive Behavioral Therapy and information about parenting skills for low-income pregnant women with depressive symptoms; and (ii) group sessions fostering child stimulation until the child is 15 months old. To evaluate the impacts, we will recruit approximately 500 low-income women with depressive symptoms and allocate them randomly to treatment and control. Outcomes will include child development measured by the Bayley and maternal and child health and development indicators available in the electronic medical records, as well as mother’s mental health and economic outcomes. Long term follow-up will eventually allow a better understanding of the impact of human capital interventions on both mother and child.