2025
Impacts of chronic suicidal ideation on parenting and child development: A longitudinal mother-child cohort study in Pakistan
Hagaman A, Frost A, Sanborn K, Zhou Y, Gallis J, Turner E, Sikander S, Rahman A, Bates L, Saeed G, Mumtaz S, Bibi A, Malik A, Maselko J. Impacts of chronic suicidal ideation on parenting and child development: A longitudinal mother-child cohort study in Pakistan. Social Science & Medicine 2025, 383: 118463. PMID: 40763404, PMCID: PMC12392297, DOI: 10.1016/j.socscimed.2025.118463.Peer-Reviewed Original ResearchConceptsIntergenerational transmissionIntimate partner violenceMaternal educational attainmentPartner violenceSuicidal ideationSI trajectoryYears of child ageEducational attainmentFine motor developmentSocioemotional scoresMiddle-income countriesMother-childChild developmentMother-child cohort studySocioemotional outcomesMotor developmentSuicide prevention programsLongitudinal trajectoriesMother-child dyadsChronic suicidal ideationSuicidal ideation groupChild ageMaternal depressionYear postpartumLinear mixed effects modelsImplementing LGBTQ-affirmative CBT: study protocol for an effectiveness-implementation trial at 90 LGBTQ community centers
Pachankis J, Chiaramonte D, Baldwin H, Prachniak C, Levine D, Van S, Hobbs R, Ankrum H, Wilkins L, Harvey T, Harkness A, Jackson S, Matsuno E, Soulliard Z, Last B, Burger J, Delehant M, Zhou X, Hagaman A, Li D, Mustanski B. Implementing LGBTQ-affirmative CBT: study protocol for an effectiveness-implementation trial at 90 LGBTQ community centers. BMC Health Services Research 2025, 25: 962. PMID: 40691571, PMCID: PMC12278521, DOI: 10.1186/s12913-025-13136-3.Peer-Reviewed Original ResearchConceptsCognitive-behavioral therapyEvidence-based practiceLGBTQ community centersEffectiveness-implementation trialCommunity centersMental healthTraining of mental health providersTrain-the-trainer formatEvidence-based practice implementationLack of evidence-based practiceHealth disparity populationsMental health providersMental health disparitiesClients' mental healthMixed-methods designLow-resource settingsYear of supervisionProvider fidelityClinical effectiveness outcomesHealth disparitiesImplementation determinantsHealth providersCBT skillsWebinar trainingDisparate populationsAssociation between prenatal depressive symptoms and receipt of recommended maternal and infant care postpartum
Masters C, Carandang R, Rojina J, Lewis J, Ickovics J, Cunningham S, Hagaman A. Association between prenatal depressive symptoms and receipt of recommended maternal and infant care postpartum. Journal Of Affective Disorders 2025, 375: 174-179. PMID: 39862978, DOI: 10.1016/j.jad.2025.01.111.Peer-Reviewed Original ResearchConceptsPrenatal depressive symptomsPostpartum check-upPrenatal depressionDepressive symptomsImpact health care accessImpact of maternal depressionCheck-UpGroup prenatal careMaternal mental healthInfant receiptHealth care accessMental health interventionsReceipt of recommended vaccinationsReceipt of vaccinationPostpartum healthcareCare accessNo significant associationHealth interventionsPostpartum individualsMaternal depressionPrenatal careYear postpartumMental healthMonths postpartumPotential confounders
2024
Piloting Implementation Design and Preliminary Readiness for Universal Suicide Risk Screening Program in Emergency Department of a Tertiary Care Centre, Nepal: A Mixed Method Study
Shrestha A, Shrestha R, Shakya R, Paudel P, Sorenson M, Gurung A, Bajracharya R, Risal A, Vijayakumar L, Hagaman A. Piloting Implementation Design and Preliminary Readiness for Universal Suicide Risk Screening Program in Emergency Department of a Tertiary Care Centre, Nepal: A Mixed Method Study. Journal Of Nepal Medical Association 2024, 62: 803-813. PMID: 40654395, PMCID: PMC11930060, DOI: 10.31729/jnma.8832.Peer-Reviewed Original ResearchConceptsSuicide risk screening programSystem prioritiesEmergency departmentScreening programImplementation packageNepal Health Research CouncilCo-design focus groupsHealth system strategiesStaff focus groupsMixed methods studyHealth Research CouncilSuicide screening toolKnowledge of staffPilot studyImplementation assessmentScreening uptakeEthical Review BoardScreening acceptanceAnticipated stigmaImplementation trialReferral processScreening packageInstitutional ethics review boardFocus groupsTertiary care centreTrauma exposure among young children in rural Pakistan: Associations with gender, mental health, and cognitive skills
Frost A, Collins A, Chung E, Escobar Carias M, Hagaman A, Gupta S, Bibi A, Sikander S, Maselko J. Trauma exposure among young children in rural Pakistan: Associations with gender, mental health, and cognitive skills. BMC Psychology 2024, 12: 454. PMID: 39183356, PMCID: PMC11346172, DOI: 10.1186/s40359-024-01944-x.Peer-Reviewed Original ResearchConceptsChild mental healthMental healthLow-resource settingsAssociated with increased mental health difficultiesRural PakistanMental health difficultiesTrauma exposureMental health problemsStrength of associationSample of mother-child dyadsIncreased anxiety scoresChildren's lifetime exposureTrauma-informed interventionsMother-child dyadsCognitive healthAssociated with genderHealth difficultiesBackgroundThe burdenAnxiety scoresHealth problemsHealthLifetime exposureExperience traumaChildren's cognitive skillsCognitive skillsIntegration of passive sensing technology to enhance delivery of psychological interventions for mothers with depression: the StandStrong study
van Heerden A, Poudyal A, Hagaman A, Maharjan S, Byanjankar P, Bemme D, Thapa A, Kohrt B. Integration of passive sensing technology to enhance delivery of psychological interventions for mothers with depression: the StandStrong study. Scientific Reports 2024, 14: 13535. PMID: 38866839, PMCID: PMC11169515, DOI: 10.1038/s41598-024-63232-3.Peer-Reviewed Original ResearchConceptsPsychological interventionsDepressive symptomsDelivery of psychological interventionsNon-specialist providersTreat maternal depressionLow-resource settingsBeck Depression InventoryPersonalized psychological interventionsDepression interventionsMaternal depressionMHealth solutionsRural NepalDepression InventoryYoung mothersInterventionDepressionData collectionMothersPassive sensingIncreased movementNon-specialistsPassive sensing technologyMHealthSymptomsCare“WOOP is my safe haven”: A qualitative feasibility and acceptability study of the Wish Outcome Obstacle Plan (WOOP) intervention for spouses of people living with early‐stage dementia
Mroz E, Schwartz A, Valeika S, Oettingen G, Marottoli R, David D, Hagaman A, Fedus D, Monin J. “WOOP is my safe haven”: A qualitative feasibility and acceptability study of the Wish Outcome Obstacle Plan (WOOP) intervention for spouses of people living with early‐stage dementia. International Journal Of Geriatric Psychiatry 2024, 39: e6092. PMID: 38687142, PMCID: PMC11448666, DOI: 10.1002/gps.6092.Peer-Reviewed Original ResearchConceptsSpouses of peopleLongitudinal semi-structured interviewsEarly-stage dementiaCodebook thematic analysisSemi-structured interviewsCare partnersIntervention deliveryBaseline strengthThematic analysisMeta-themesQualitative studyBehavioral interventionsAreas of improvementDementiaQualitative feasibilityMental exerciseInterventionSpousesWell-beingEmotional stressorsIntervention mechanismsParticipantsAcceptability studyWishesPeopleChildhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan
Frost A, Hagaman A, Bibi A, Bhalotra S, Chung E, Haight S, Sikander S, Maselko J. Childhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan. Journal Of Affective Disorders 2024, 356: 715-721. PMID: 38663557, PMCID: PMC11103589, DOI: 10.1016/j.jad.2024.04.090.Peer-Reviewed Original ResearchConceptsParental Bonding InstrumentStructured Clinical Interview for DSM DisordersRisk of depressionPsychological controlParenting behaviorsMental healthAssociated with decreased risk of depressionParent-child relationship qualityMeasures of parental controlAssociated with increased risk of depressionDepression in adulthoodRural PakistanMental health of childrenBehavioral controlRetrospective self-reportsMothers' parenting behaviorImpact of parenting behaviorsChild mental healthChildhood parental bondingAssociated with decreased riskHealth of childrenCross-sectional studyAssociated with increased riskDSM disordersAdulthood depression
2023
Navigating and manipulating childbirth services in Afar, Ethiopia: A qualitative study of cultural safety in the birthing room
Hagaman A, Rodriguez H, Egger E, Bitewulign B, Case H, Alemayehu A, Rhodes E, Estifanos A, Singh K, Keraga D, Zahid M, Magge H, Barrington C. Navigating and manipulating childbirth services in Afar, Ethiopia: A qualitative study of cultural safety in the birthing room. Social Science & Medicine 2023, 331: 116073. PMID: 37481879, PMCID: PMC10410251, DOI: 10.1016/j.socscimed.2023.116073.Peer-Reviewed Original ResearchConceptsCultural safetyPower dynamicsSafety frameworkSemi-structured interviewsDistinct cultural traditionsHealth systemRich cultural diversityGovernment health facilitiesCultural diversityCultural traditionsThematic analysisQualitative studyMaternal health servicesChildbirth servicesHealth facilitiesHealth servicesAfar regionPast decadeEthiopiaFrameworkGovernmentWieldWomenServicesAfar
2022
Stressful life events, intimate partner violence, and perceived stress in the postpartum period: longitudinal findings in rural Pakistan
Haight SC, Gallis JA, Chung EO, Baranov V, Bibi A, Frost A, Hagaman A, Sikander S, Maselko J, Bates LM. Stressful life events, intimate partner violence, and perceived stress in the postpartum period: longitudinal findings in rural Pakistan. Social Psychiatry And Psychiatric Epidemiology 2022, 57: 2193-2205. PMID: 36050505, PMCID: PMC10084399, DOI: 10.1007/s00127-022-02354-3.Peer-Reviewed Original ResearchPsychosocial training and support guidelines for research staff
Burgess R, Kim AW, Cele L, Khadka S, Sigdel K, Hagaman AK. Psychosocial training and support guidelines for research staff. Bulletin Of The World Health Organization 2022, 100: 578-580. PMID: 36062239, PMCID: PMC9421552, DOI: 10.2471/blt.21.287159.Peer-Reviewed Original ResearchNon-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan.
Frost A, Hagaman A, Baranov V, Chung EO, Bhalotra S, Sikander S, Maselko J. Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan. Development And Psychopathology 2022, 35: 2086-2095. PMID: 35959681, PMCID: PMC9922341, DOI: 10.1017/s0954579422000773.Peer-Reviewed Original ResearchConceptsHPA axis activityMental health difficultiesAxis activityHealth difficultiesEarly childhoodHypothalamic pituitary adrenal axis activityPituitary-adrenal axis activitySDQ scoresAdrenal axis activityNon-linear associationLongitudinal cohortDepression trialsQuadratic associationHair cortisolDehydroepiandosteroneRural PakistanMental healthCortisolEarly adversitySignificant quadratic associationDifficulties QuestionnaireLow-resource contextsChildhoodChildrenAssociation“Now, I have my baby so I don’t go anywhere”: A mixed method approach to the ‘everyday’ and young motherhood integrating qualitative interviews and passive digital data from mobile devices
Hagaman A, Mercado D, Poudyal A, Bemme D, Boone C, van Heerden A, Byanjankar P, Maharjan S, Thapa A, Kohrt BA. “Now, I have my baby so I don’t go anywhere”: A mixed method approach to the ‘everyday’ and young motherhood integrating qualitative interviews and passive digital data from mobile devices. PLOS ONE 2022, 17: e0269443. PMID: 35802694, PMCID: PMC9269952, DOI: 10.1371/journal.pone.0269443.Peer-Reviewed Original ResearchAdverse childhood experiences and implications of perceived stress, anxiety and cortisol among women in Pakistan: a cross-sectional study
Ikram N, Frost A, LeMasters K, Hagaman A, Baranov V, Gallis J, Sikander S, Scherer E, Maselko J. Adverse childhood experiences and implications of perceived stress, anxiety and cortisol among women in Pakistan: a cross-sectional study. BMJ Open 2022, 12: e052280. PMID: 35428618, PMCID: PMC9014037, DOI: 10.1136/bmjopen-2021-052280.Peer-Reviewed Original Research“Even though they insult us, the delivery they give us is the greatest thing”: a qualitative study contextualizing women’s experiences with facility-based maternal health care in Ethiopia
Hagaman A, Rodriguez HG, Barrington C, Singh K, Estifanos AS, Keraga DW, Alemayehu AK, Abate M, Bitewulign B, Barker P, Magge H. “Even though they insult us, the delivery they give us is the greatest thing”: a qualitative study contextualizing women’s experiences with facility-based maternal health care in Ethiopia. BMC Pregnancy And Childbirth 2022, 22: 31. PMID: 35031022, PMCID: PMC8759250, DOI: 10.1186/s12884-022-04381-z.Peer-Reviewed Original ResearchConceptsWomen's care experiencesMaternal healthcareCare experiencesDelivery experienceElicit women's experiencesMaternal care servicesMaternal health careWomen's overall satisfactionPoor-quality facilitiesOverall satisfactionWomen's experiencesSemi-structured interview guideAntenatal careCare registriesAdverse outcomesSix-month periodNewborn survivalConclusionOur findingsMaternal survivalCare servicesWomen's satisfactionPlace of birthDonabedian frameworkMHC experiencesHealthy outcomesMother-in-law childcare and perinatal depression in rural Pakistan
Chung E, Hagaman A, Bibi A, Frost A, Haight S, Sikander S, Maselko J. Mother-in-law childcare and perinatal depression in rural Pakistan. Women's Health 2022, 18: 17455057221141288. PMID: 36468464, PMCID: PMC9726850, DOI: 10.1177/17455057221141288.Peer-Reviewed Original ResearchConceptsPerinatal depressionMaternal mental healthMonths postpartumMental healthImmediate postpartum periodFirst year postpartumStructured Clinical InterviewCross-sectional associationsHigh motherMental Disorders-IVYear postpartumLife Events ChecklistPostpartum periodMajor depressionPerinatal periodMaternal depressionLow prevalenceBirth cohortClinical InterviewLow motherPostpartumRural PakistanStatistical ManualDepressionMothers
2021
Passive sensing on mobile devices to improve mental health services with adolescent and young mothers in low-resource settings: the role of families in feasibility and acceptability
Maharjan SM, Poudyal A, van Heerden A, Byanjankar P, Thapa A, Islam C, Kohrt BA, Hagaman A. Passive sensing on mobile devices to improve mental health services with adolescent and young mothers in low-resource settings: the role of families in feasibility and acceptability. BMC Medical Informatics And Decision Making 2021, 21: 117. PMID: 33827552, PMCID: PMC8025381, DOI: 10.1186/s12911-021-01473-2.Peer-Reviewed Original ResearchConceptsINTERNATIONAL REGISTERED REPORT IDENTIFIERHealth servicesMajor modifiable factorsYoung mothersChild health servicesMental health servicesFeasibility challengesLow-resource settingsMaternal-child interactionDepression treatmentModifiable factorsVaccination clinicsPostpartum depressionFamily involvementPhysical activityEligibility criteriaMother-infant proximityMental healthcareGreater family involvementPsychological interventionsMothersDaily activitiesRural NepalInfantsImproved communicationWhat Does Social Support Sound Like? Challenges and Opportunities for Using Passive Episodic Audio Collection to Assess the Social Environment
Poudyal A, van Heerden A, Hagaman A, Islam C, Thapa A, Maharjan SM, Byanjankar P, Kohrt BA. What Does Social Support Sound Like? Challenges and Opportunities for Using Passive Episodic Audio Collection to Assess the Social Environment. Frontiers In Public Health 2021, 9: 633606. PMID: 33855008, PMCID: PMC8039317, DOI: 10.3389/fpubh.2021.633606.Peer-Reviewed Original ResearchConceptsNegative social interactionsSocial environmentSocial interactionSocial supportMental healthNegative stimuliSpeech exposureQuality of interactionPositive soundsAdult speechInfant babblingQualitative interviewsAccuracy scoresSpeechPre-trained modelCommon soundsSocial isolationYoung mothersAudio clipsAudio dataSoundAudio collectionsAudioLaughterHealth outcomesLongitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach
Hagaman A, LeMasters K, Zivich PN, Sikander S, Bates LM, Bhalotra S, Chung EO, Zaidi A, Maselko J. Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach. Journal Of Epidemiology & Community Health 2021, 75: 936-943. PMID: 33712512, PMCID: PMC8434957, DOI: 10.1136/jech-2020-215836.Peer-Reviewed Original ResearchConceptsMaternal Social Support IndexMonths postpartumPerinatal periodMaternal depressionProtective effectSocial supportCohort of womenMajor depressive disorderStructured Clinical InterviewYear of childbirthSubsequent maternal depressionComplex bidirectional relationshipSustained social supportFuture depressive episodesSocial Support IndexMarginal structural modelsPerinatal depressionThird trimesterDecreased riskImportant protective factorDepressive episodeDepressive disorderPostpartum depressionHigh burdenClinical InterviewAdverse childhood experiences and depression among women in rural Pakistan
LeMasters K, Bates LM, Chung EO, Gallis JA, Hagaman A, Scherer E, Sikander S, Staley BS, Zalla LC, Zivich PN, Maselko J. Adverse childhood experiences and depression among women in rural Pakistan. BMC Public Health 2021, 21: 400. PMID: 33632175, PMCID: PMC7905421, DOI: 10.1186/s12889-021-10409-4.Peer-Reviewed Original ResearchConceptsMajor depressive episodeSymptom severityPerinatal mental health interventionsWomen's depressionBackgroundAdverse childhood experiencesDepressive symptom severityMajority of womenACE-International QuestionnaireCurrent mental healthMental health interventionsAdverse childhood experiencesChildhood experiencesCohort studyDepressive episodeMonths postpartumPerinatal periodElevated riskPronounced elevationHealth interventionsMore ACEsRural PakistanMental healthFamily distressCommon pathwayDepression
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