PROJECT SUMMARY/ABSTRACT The goal of this pilot study is to adapt and pilot-test a novel mental health prevention intervention for migrant mothers with young children (MMC) in a humanitarian setting. Global migration is rising at record-high rates, with the number of women traveling with children continuing to rise at the U.S.-Mexico border. Tijuana, Mexico is located at the busiest land border crossing globally and faces an unprecedented humanitarian crisis resulting from displacement due to violence, political conflict, lack of economic opportunity, and climate change, exacerbated by migration policies that have forced hundreds of thousands of migrants to wait in Mexico under prolonged and unsafe conditions. Migrant women in transit in such contexts face high risk of developing mental disorders such as depression and anxiety, driven by gendered social-structural factors including violence, social isolation, migration uncertainty, and limited access to services. Although migrants in transit who endure such conditions have high need for mental health prevention, few evidence-based interventions are tailored to migrant women in transit. Moreover, while women and children’s mental health in humanitarian contexts are interconnected, few mental health interventions address parenting needs. We propose to adapt ‘Mamá Empoderada’ [Mom Power] - a theory-based, trauma-informed group intervention to promote mental health and positive parenting among mothers with young children (0-5 years) for the first time with MMC. This multi- component intervention includes a parenting program alongside activities to address social-structural vulnerabilities (e.g., connection to resources, strengthening social support). It has demonstrated efficacy on reduced parenting stress and mental health symptoms for trauma-exposed U.S. mothers and has recently been translated into Spanish. Our specific aims are to 1) Adapt, pre-test, and refine ‘Mamá Empoderada’ with MMC in a humanitarian context; 2) Conduct a pilot study of the adapted intervention to determine acceptability and estimate effect sizes on symptoms of depression, anxiety, and parenting stress; and 3) Explore which theory-based mechanisms of action predict changes in symptoms of depression, anxiety, and parenting stress, and identify factors associated with differential intervention response. We will conduct focus groups and pre- testing to adapt and refine the intervention, and conduct a pilot RCT of the adapted intervention with MMC (N=100; Ntreatment=50; Ncontrol=50). The intervention group (IG) will receive trauma-informed group and individual sessions on parenting, linkage to resources (e.g., food, shelter), social support, and resilience. The control group will receive written intervention materials, standard of care programming, and participate in the intervention following completion of the study by the IG (i.e., after 6 months). Both groups will complete baseline and exit surveys, as well as follow-up surveys at 3- and 6- months post-intervention. Amid rising population displacement and prolonged and traumatic migration journeys, this study addresses an urgent need for scalable and tailored mental health prevention for MMC in transit in humanitarian contexts.

PROJECT NARRATIVE Global migration is rising at record-high rates, particularly at the U.S.-Mexico border, which is facing an unprecedented humanitarian crisis resulting from population displacement due to violence, political conflict, lack of economic opportunity, and climate change, exacerbated by immigration policies that have resulted in prolonged migration journeys for large volumes of migrants waiting to enter the U.S. While migrant women in transit in such contexts face high risk of developing mental disorders such as depression and anxiety, few evidence-based mental health prevention interventions are tailored to migrant women in transit, with a particular paucity of programs that address gendered social-structural vulnerabilities (e.g., social isolation, unmet resource needs) and parenting. As such, the goal of this study is to adapt and pilot-test a novel multi-component mental health prevention intervention for migrant mothers with young children (MMC) in the humanitarian setting of Tijuana, Mexico.