Understanding the Complexity of Individual and Clustered Behavioral Health Risks Experienced By Mothers

Background

Over the past decade, there has been an increase in awareness as it relates to women’s health, specific to the impact of psychosocial risks as it relates to mothers (Price & Masho, 2014). Maternal and child health programs have enhanced their services by providing behavioral health screens (Price & Masho, 2014); however, while placing a specified emphasis on depression, other psychosocial factors are viewed in a separate capacity. The literature has demonstrated that parental psychosocial risks have the potential to contribute to adverse outcomes for children inclusive of social problems, substance abuse, physical health concerns (Ringoot et. al, 2015), and familial violence.  While many studies screen participants for several of these specific indicators, the interface of these concomitant risks has been less studied.  This study employed a secondary data analysis of the Fragile Families and Child Well-Being Study (Year 15) data to assess individual and clustered behavioral health risk identification of biological mothers.

Methods/Approach:

This study utilized data from the Fragile Families and Child Well-Being Study (FFCW) Year 15 dataset.  An adapted version of the Institute for Health and Recovery’s Behavioral Health Risk Screen (BHRS), PHQ-2, Edinburgh Postnatal Depression Scale (EPDS), and additional anxiety questions were used to examine behavioral risk: depression, substance use, and smoking usage among biological mothers. Descriptive bivariate analyses were conducted to examine the associations individual behavioral health risks including depression, substance use and smoking usage of biological mothers (N=1,589).  Next, a two-step cluster analysis was performed to organize behavioral health risks experienced by women (i.e. depression, substance use, alcohol, and smoking) into mutually exclusive groups.

Findings:

In this sample, 17.5% of participants (N=257) triggered emotional health risk using the EPDS.  Depressive symptoms were associated with concurrent smoking (F=2.4, p=.0005), and interpersonal violence, (F=4.24, p=.040), although substance usage and drinking did not contribute to the model. The two-step cluster analysis produced three clusters of functioning.  The largest of the obtained clusters (28.7%) was labeled feeling blue and characterized by positive functioning in three domains. Nearly all of its members (87%) had experiences of depression, half of the members smoked (52%), and almost half of the women reported alcohol usage (40%). The second cluster, labeled smoking cluster, (24%) was characterized by smoking usage for all members (100%) and alcohol usage by almost half of the members (49%). The third and smallest cluster (21.1%), labeled alcohol usage, was characterized by alcohol usage for all members, but no experiences of depression, smoking, or substance usage.  Cluster differences were significant (F=3.38, p<.05).

Implications

Screening mothers for individual psychosocial risks fails to meet the complexity of psychosocial needs in the lived experiences of many women and families. Mothers are experiencing behavioral health risks individually and concomitantly; thus, more comprehensive screening protocols are needed to gain understanding of the complexity of women’s lived experience and their psychosocial needs in efforts to decrease community and familial violence.