TY - JOUR
KW - collaborative care
KW - perinatal depression
KW - obstetric clinic
KW - rural
AU - Amritha Bhat
AU - Susan Reed
AU - Johnny Mao
AU - Mindy Vredevoogd
AU - Joan Russo
AU - Jennifer Unger
AU - Roger Rowles
AU - Jurgen Unutzer
A1 - 
AB - OBJECTIVES: Universal screening for depression during pregnancy and postpartum is recommended, yet mental health treatment and follow-up rates among screen-positive women in rural settings are low. We studied the feasibility, acceptability and effectiveness of perinatal depression treatment integrated into a rural obstetric setting. METHODS: We conducted an open treatment study of a screening and intervention program modified from the Depression Attention for Women Now (DAWN) Collaborative Care model in a rural obstetric clinic. Depression screen-positive pregnant and postpartum women received problem-solving therapy (PST) with or without antidepressants. A care manager coordinated communication between patient, obstetrician and psychiatric consultant. We measured change in the Patient Health Questionnaire 9 (PHQ-9) score. We used surveys and focus groups to measure patient and provider satisfaction and analyzed focus groups using qualitative analysis. RESULTS: The intervention was well accepted by providers and patients, based on survey and focus group data. Feasibility was also evidenced by recruitment (87.1%) and retention (92.6%) rates and depression outcomes (64% with >50% improvement in PHQ 9) which were comparable to clinical trials in similar urban populations. Conclusions for practice: DAWN Collaborative Care modified for treatment of perinatal depression in a rural obstetric setting is feasible and acceptable. Behavioral health services integrated into rural obstetric settings could improve care for perinatal depression.
AD - a Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA.; b Department of Obstetrics and Gynecology , University of Washington , Seattle , WA , USA.; a Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA.; a Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA.; a Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA.; b Department of Obstetrics and Gynecology , University of Washington , Seattle , WA , USA.; b Department of Obstetrics and Gynecology , University of Washington , Seattle , WA , USA.; c Generations Obstetrics and Gynecology , Yakima , WA , USA.; a Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA.
BT - Journal of psychosomatic obstetrics and gynaecology
C5 - Education & Workforce; Healthcare Disparities; Measures
CP - 4
CY - England
DO - 10.1080/0167482X.2017.1367381
IS - 4
JF - Journal of psychosomatic obstetrics and gynaecology
LA - eng
M1 - Journal Article
N2 - OBJECTIVES: Universal screening for depression during pregnancy and postpartum is recommended, yet mental health treatment and follow-up rates among screen-positive women in rural settings are low. We studied the feasibility, acceptability and effectiveness of perinatal depression treatment integrated into a rural obstetric setting. METHODS: We conducted an open treatment study of a screening and intervention program modified from the Depression Attention for Women Now (DAWN) Collaborative Care model in a rural obstetric clinic. Depression screen-positive pregnant and postpartum women received problem-solving therapy (PST) with or without antidepressants. A care manager coordinated communication between patient, obstetrician and psychiatric consultant. We measured change in the Patient Health Questionnaire 9 (PHQ-9) score. We used surveys and focus groups to measure patient and provider satisfaction and analyzed focus groups using qualitative analysis. RESULTS: The intervention was well accepted by providers and patients, based on survey and focus group data. Feasibility was also evidenced by recruitment (87.1%) and retention (92.6%) rates and depression outcomes (64% with >50% improvement in PHQ 9) which were comparable to clinical trials in similar urban populations. Conclusions for practice: DAWN Collaborative Care modified for treatment of perinatal depression in a rural obstetric setting is feasible and acceptable. Behavioral health services integrated into rural obstetric settings could improve care for perinatal depression.
PP - England
PY - 2018
SN - 1743-8942; 0167-482X
SP - 273
EP - 280
EP - 
T1 - Delivering perinatal depression care in a rural obstetric setting: a mixed methods study of feasibility, acceptability and effectiveness
T2 - Journal of psychosomatic obstetrics and gynaecology
TI - Delivering perinatal depression care in a rural obstetric setting: a mixed methods study of feasibility, acceptability and effectiveness
U1 - Education & Workforce; Healthcare Disparities; Measures
U2 - 28882096
U3 - 10.1080/0167482X.2017.1367381
VL - 39
VO - 1743-8942; 0167-482X
Y1 - 2018
Y2 - Dec
ER -