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Montefiore in the News

September 30, 2021

Study Will Evaluate Best Way to Support Psychological Well-Being of Bronx Caregivers

BRONX, NY – The Bronx has been hit disproportionally by COVID-19. For caregivers in the borough, the pandemic has caused unprecedented psychological distress. In addition to existing health disparities, these families now face greater financial insecurity and challenges related to their school-aged children. 

Now, the National Institutes of Health (NIH) has awarded researchers at Montefiore Health System and Albert Einstein College of Medicine a five-year, $4.1 million grant to study interventions to reduce symptoms of depression and anxiety among Bronx caregivers and healthcare workers.

"As a psychiatrist and mom, I want caregivers in the Bronx to have the tools to be confident in tough parenting situations and tackle stress and uncertainty in a healthy way,” said Vilma Gabbay, M.D., M.S., principal investigator on the grant, co-director of the Psychiatry Research Institute at Montefiore Einstein, and associate professor of psychiatry and behavioral sciences and in the Dominick P. Purpura Department of Neuroscience at Einstein.

Supporting Parents With High Stress

The Montefiore-Einstein study will enroll 360 Bronx parents and other primary caregivers for kids and teens. The participants, who will receive psychological support, will be selected from among three groups who face unique vulnerabilities during the on-going COVID-19 pandemic:

  • Parents and caregivers of children who have autoimmune illnesses like lupus and juvenile arthritis, and may develop serious illness following COVID-19 infection
  • Parents and caregivers of children who have existing psychiatric conditions and are at higher risk for pandemic-related anxiety and depression
  • Frontline healthcare workers at Montefiore who are parents under increased stress during the pandemic

Group Therapy vs. Parental Education vs. Combined Approach

The randomized trial will evaluate three approaches. One-third of the participants will receive 12 weeks of group telehealth therapy, expanding on the work of the Connecting and Reflecting Experience (CARE), a group-based program at Montefiore and Einstein. In these telehealth sessions, a group leader helps caregivers “mentalize” by encouraging them to recognize and understand what motivates their children’s behavior, while examining their own thoughts and feelings. The CARE program is adapted from the work of Nancy Suchman, Ph.D., the late mentor of Amanda Zayde, Psy.D., assistant professor of psychiatry and behavioral sciences at Einstein. Dr. Suchman was a researcher at the Yale School of Medicine and a pioneer of this approach for fostering the connection between mothers and young children.

“In the group sessions, parents have the opportunity to connect with other caregivers and share common experiences, normalizing challenges,” said Dr. Zayde. "For example, they might wonder about and discuss why a child would spend hours online during the pandemic. Additionally, participants support each other and share community resources.”

The CARE program was developed seven years ago for caregivers, often recent immigrants, who face health disparities and who are raising children with a range of mental health conditions. In previous research, people who completed the program reported decreased symptoms of anxiety and depression plus decreases in parenting stress.

Another third of the participants will receive 12 weeks of parenting education supported by the Valera Health app, with a focus on teaching caregivers problem-solving, communication, and coping skills.

“We want to help Bronx residents lower anxiety and depression symptoms by building skills to support their children and manage distress,” said Jonathan Alpert, M.D., Ph.D., professor and chair of psychiatry and behavioral sciences and co-principal investigator on the grant. Dr. Alpert is also professor in the Dominick P. Purpura Department of Neuroscience, and of pediatrics, and the Dorothy and Marty Silverman Chair in Psychiatry at Einstein.

Participants in this part of the study will have upgraded resources in the Valera Health app, including articles on addressing children’s emotions and behaviors, created with input from Sandra S. Pimentel, Ph.D., associate professor of psychiatry and behavioral sciences at Einstein. Additionally, parents will be able to use the app to communicate with their children’s care teams.

The last third of participants will receive both programs: parental education via the Valera Health app and the online CARE program.

Using Technology to Improve Outcomes

All participants who are not healthcare workers will be provided with smartphones to use the basic functions of the Valera Health app, including messaging, which has been shown to increase communication with health care teams —a significant issue for Bronx residents.

Researchers will use machine learning approaches to explore complex patterns in the data to identify factors—COVID-19 illness, psychiatric diagnoses, housing, poverty, and trauma, for example—that can help predict psychological and health outcomes.

The grant, titled “A Multimodal Parent-focused Intervention for Vulnerable Populations in the Bronx,” is supported by the National Institute for Mental Health, part of the NIH (R01MH126821).




About Montefiore Health System

Montefiore Health System is one of New York’s premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 10 hospitals, including the Children's Hospital at Montefiore, Burke Rehabilitation Hospitaland more than 200 outpatient ambulatory care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information, please visit Follow us on Twitter and Instagram and LinkedIn, or view us on Facebook and YouTube.


About Albert Einstein College of Medicine

Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2020-21 academic year, Einstein is home to 721 M.D. students, 178 Ph.D. students, 109 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2020, Einstein received more than $197 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit Follow us on Twitter and Instagram and LinkedIn, or view us on Facebook and YouTube.