Person: Awad Sirhan, Natalia
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Awad Sirhan
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Natalia
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Publication Cultural adaptation of an intervention to prevent postnatal depression and anxiety in Chilean new mothers(2019) Coo, Soledad; García, María Ignacia; Rowe, Heather; Fisher, Jane; Awad Sirhan, NataliaObjective: The aim of this study was to culturally adapt What Were We Thinking (WWWT), an Australian psychoeducational intervention to prevent symptoms of depression and anxiety among firsttime mothers, to be used in the Chilean primary health system. Background: Mental health symptoms are common in first-time mothers. Despite the availability of effective screening and referral in the Chilean primary health system, very few women access treatment due to diverse barriers. This highlights the importance of using a preventive approach. The evidence that culturallyadapted, evidence-based preventive programmes can reduce maternal mental health problems supports the development of this study. Methods: WWWT materials were translated into Spanish. Cultural Adaptation and field testing were conducted following the Cultural Adaptation Model. Results: Modifications to the intervention included adding an explicit infant mental health approach, a simplification of written information, and changes in the number and duration of the sessions. The adapted version of WWWT was considered understandable and relevant for local perinatal mental health specialists, new mothers and their partners. Conclusion: The Spanish version of WWWTis a culturally sensitive intervention, its potential for effective use in the Chilean context warrants further investigation. Limitations and implications for future studies are discussed.Publication Cross-national risk factors for childbirth-related PTSD: Findings from the INTERSECT study(2025) Handelzalts, Jonathan E.; Ayers, Susan; Webb, Rebecca; Constantinou, Georgina; Lucas, Grace; Grollman, Christopher; Ohayon, Shay; Awad Sirhan, Natalia; Baird, Kathleen; Baldisserotto, Márcia; Batool, Ramish; Batool, Shahida; Caparros-Gonzalez, Rafael A.; Chorwe-Sungani, Genesis; Christoforou, Andri; Coo, Soledad; Costa, Raquel; Dikmen-Yildiz, Pelin; Ďuríčeková, Barbora; Dušová, Bohdana; Enea, Violeta; Garthus-Niegel, Susan; Grundström, Hanna; Gureje, Oye; Hadjigeorgiou, Eleni; Marie Haga, Silje; Horsch, Antje; Ionio, Chiara; Jarašiūnaitė-Fedosejeva, Gabija; Jomeen, Julie; Kazmierczak, Maria; Lalor, Joan; Milosavljevic, Maja; Nagle, Ursula; Nakić Radoš, Sandra; Nieminen, Katri; Damilola Oladeji, Bibilola; Osório, Flavia; Pawlicka, Paulina; Peled, YoavBackground: Childbirth-related post-traumatic stress disorder (CB-PTSD) is an underrecognized condition with consequences for mothers and infants. This study aimed to determine risk factors for CB-PTSD symptoms across countries within a stress-diathesis framework, focusing on antenatal, birth-related, and postpartum predictors. Methods: The INTERSECT cross-sectional survey (April 2021-January 2024) included 11,302 women at 6-12 weeks postpartum. The study was carried out across maternity services in 31 countries. Outcomes were CB-PTSD diagnosis, symptom severity, and perceived traumatic birth, assessed with the City Birth Trauma Scale. Multiple risk factors were assessed, including preexisting vulnerability, pregnancy, birth, and infant related factors. All models were adjusted for country-level variation as a random effect. Results: Models explained substantial variance across all outcomes (conditional R2 = 0.53-0.58). Negative birth experience was the strongest predictor (e.g. odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.80-0.84 for diagnosis). Ongoing maternal complications predicted both CB-PTSD diagnosis and symptoms (e.g. OR = 1.61, 95% CI = 1.41-1.84), and major infant complications were associated with CB-PTSD diagnosis (OR = 1.63, 95% CI = 1.29-2.07). Reports of perceived danger to self or infant (criterion A) were linked to higher CB-PTSD symptoms and traumatic birth ratings (e.g., β =0.25, 95% CI = 0.21-0.29). Other predictors reached significance but showed small effects. Conclusions: Findings support a stress-diathesis framework, showing that while pre-existing vulnerabilities contribute, birth-related stressors exert the strongest influence. Trauma-informed maternity care should prioritize these factors, with attention to women's appraisals of birth.