Assessing Postpartum Depression During Well-Child Examinations: Are Needs Being Met?

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Postpartum depression (PPD) refers to the onset of depressive symptoms anytime within first year following the birth of a child. PPD affects approximately 10-20% of new mothers and often goes underdiagnosed and untreated. Left untreated, PPD can predispose women to more severe and frequent future depressive episodes. Literature suggests depression in mothers may have long-term negative effects on infants’ and children’s psychosocial development. The American Academy of Pediatrics (AAP) has identified pediatric primary care as the ideal location to screen and refer mothers possibly suffering from depression. Routinely assessing PPD in mothers during well-child checks is not only recommended, it is increasingly being considered a best practice standard. The AAP calls for further research to improve the feasibility of assessing and treating PPD in mothers in pediatric primary care. This paper is part of a larger study that will be evaluating the effectiveness of screening new mothers for PPD in pediatric primary care settings and providing a brief same day interventions. The current aims of this portion of the study will be to evaluate 1) referral results, and 2) mothers’ level of satisfaction with the protocol. Research assistants (RA) will approach mothers of infants, birth to 6 months of age in the waiting rooms of ETSU Pediatrics in Johnson City, TN. Mothers will be given a brief description of PPD, the study and will be asked to participate by signing a voluntary informed consent document. As part of the visit, nurses will distribute and score the Edinburg Postpartum Depression Scale (EPDS). Mothers scoring 9 or above will receive a brief educational brochure about PPD, a brief intervention and a one week follow-up phone call with an onsite behavioral health consultant (BCH) or social worker (SW). At mothers’ discretion, an appropriate outside referral to preferred provider will be made, if necessary. Approximately two weeks postintervention, a satisfaction survey by phone will be administered by RAs. The survey will examine referral results (e.g., of high scores, what recommendations were made, did mothers follow through, treatments received, was there improvement in EPDS score) and the mothers’ level of satisfaction with the protocol (e.g., satisfaction with how protocol was handled by staff and how well mothers felt their needs were addressed). Satisfaction will be noted on a likert-scale ranging from 0 (no satisfaction) to 10 (very satisfied). Data is pending and collection will start during the first week of March showing EDPS uptake, referral results and mother satisfaction. Data is expected for approximately 60-100 new mothers.


Johnson City, TN

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