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Evaluating an Online Intervention to Improve Provider Management of Prenatal Depression: Randomized Control Trial

Published:October 17, 2022DOI:https://doi.org/10.1016/j.whi.2022.08.009

      Abstract

      Introduction

      Prenatal depression is associated with numerous deleterious maternal and child health outcomes. Providers play a significant role in managing (i.e., identifying and treating or referring to care for) prenatal depression. We conducted a randomized controlled trial to test the effects of a brief online training on self-reported provider management practices related to prenatal depression.

      Methods

      Providers (i.e., physicians, nurses, mental health specialists, and public health educators) were randomized into intervention (i.e., online training) or waitlist control arms. The online training covered guidelines and evidence-based practices related to managing prenatal depression. Changes in providers’ knowledge, attitudes, and self-reported practices were assessed by the Management of Maternal Depression Inventory at baseline (T1), 6 weeks after baseline (T2), and 12 weeks after baseline (T3).

      Results

      A total of 108 providers from Colorado and Virginia participated in the trial. Over the three time periods, repeated measures analysis of variance revealed Time × Group relative improvements for the intervention group with respect to satisfaction with working with mental health services, F(1,97) = 10.89, p = .001, partial η2 = 0.10, and increased self-reported screening, counseling, and referral for prenatal depression, F(1,97) = 6.25, p = .014, partial η2 = 0.06. A similar improving pattern was observed for self-efficacy, F(1,99) = 2.48, p = .13, partial η2 = .02.

      Conclusions

      Findings from our study suggest a brief online training may enhance the likelihood of providers screening, treating, and/or referring at-risk patients for follow-up care for prenatal depression.
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      Biography

      Jenn A. Leiferman, PhD, has spent 20 years working in mental health, focused on developing and testing prevention and treatment strategies for perinatal and child mental health. Her work has also focused on improving access to care for perinatal mood disorders.

      Biography

      Angela E. Lee-Winn, PhD's, work is centered on using interdisciplinary approaches to reduce health disparities in detection and service use, particularly in the context of substance misuse. Her research interests include perinatal substance use prevention and harm reduction, focusing on implementation science.

      Biography

      Rachael Lacy, MPH, is specialized in global community and behavioral health with research experience in the perinatal period.

      Biography

      James F. Paulson, PhD's, research focuses on pregnancy, postpartum, and early family, including maternal and paternal perinatal depression, development of harsh parenting behaviors, establishment of parenting styles and parental decision-making, individual decisions around committed relationships, and LGBTQ issues and parenthood.