Role of Family Decision-Making and Perceived Social Support in the Mental Health of Mothers of Infants in Rural Western China.

Background: The mental health of mothers has an important impact on both the growth and development of infants and on the health of mothers themselves. Family decision-making may play an important role in mother's mental health, yet little research has explored the relationship. This paper explores the association and influential pathways between family decision-making and mental health among mothers of infants in rural western China. Methods: : Mothers with infants aged 0-6 months in four impoverished counties of a predominantly rural province in southwestern China were enrolled in 2021 from the control group of a cluster-randomized trial using a multistage sampling method and followed up 6 months later. Information on family decision-making, perceived social support, and maternal mental health was collected through household interviews. Causal mediation analysis was employed to explore the association between family decision-making and mental health, and a four-item decomposition was used to explore the control direct effect of family decision-making on mental health, the pure mediation effect of perceived social support, and the possible interaction between exposure and mediation. Results: Baseline data was collected on 444 mother-infant pairs and 331 were followed up 6 months later. After controlling for the set of confounding factors indicated by our causal framework, the results of longitudinal causal mediation analyses showed that family decision-making was negatively associated with depression, anxiety, and stress after controlling for confounding factors ( Conclusions: Family decision-making had a direct negative effect on maternal depression, anxiety, and stress, and perceived social support played a mediating role. These findings can be used to guide future interventions to improve maternal mental health and healthy child development in rural China.