ABSTRACT
Summary: Maternal morbidity and mortality are at an all-time high in Texas, particularly among Latina women.
One major contributor to this public health crisis is under-treated mental health conditions. The purpose of this
Career Development Award is to provide Dr. Petruzzi with the training, career development, and mentorship
necessary to improve maternal mental health outcomes among Latina women through a culturally-adapted,
intervention that simultaneously addresses mental health and social needs. Candidate: Dr. Petruzzi is a health
equity researcher and a research associate in the Division of Community Engagement and Health Equity at the
Department of Population Health of Dell Medical School. She is a clinical social worker and has over a decade
of research experience in hospital and healthcare settings. While she has expertise in mental health and social
needs, her career will be propelled by acquisition of skills in intervention development, cultural adaptation, and
clinical trial design. Mentorship: Mentors are nationally recognized investigators with complementary
expertise: Dr. Carmen Valdez (Latina maternal mental health), Dr. Deborah Parra-Medina (intervention
development and cultural adaptation) and Dr. Emily Miller (perinatal mental health and clinical trials). Several
advisors will support this proposal, including an expert in problem solving therapy (Dr. Sampson), an expert in
perinatal patient navigation (Dr. Yee) and a biostatistician (Dr. Hobbs). Training: Dr. Petruzzi will receive both
didactic and experiential training in community intervention development, cultural adaptation, and hybrid
effectiveness implementation clinical trial design through coursework, workshops, meetings with mentors and
advisors, conferences, and manuscript writing. Research: Maternal mortality is at an all-time high in Texas,
particularly among Latina women. Mental health risk factors such as depression and suicidality have been
identified as the leading cause of maternal mortality. Evidence based interventions such as patient navigation
and problem-solving therapy have been developed to improve maternal health outcomes among racial and
ethnic minorities. However, few interventions address both mental health and social needs, and even fewer are
culturally or linguistically adapted, which could improve feasibility and acceptability among Latina women. This
proposal is innovative in combining two evidence-based interventions (problem-solving therapy and patient
navigation) to improve perinatal mental health among Latinas. The specific aims are: 1) conduct a community
assessment to identify the culturally relevant mental health and social needs of pregnant/postpartum Latina
women in Central Texas; 2) combine, culturally and linguistically adapt two evidence-based interventions
(problem-solving therapy and patient navigation) for pregnant Latina women to simultaneously address mental
health and social needs; and 3) conduct a feasibility study to assess acceptability and feasibility of the
intervention. Preliminary data from the feasibility study will inform a R01 hybrid effectiveness implementation
clinical trial to generate the necessary evidence to improve rates of maternal mortality among Latina women.