TY - JOUR
AU - M. Zimmermann
AU - G. Masters
AU - P. Sankaran
AU - J. Flahive
AU - R. C. Sheldrick
AU - J. Allison
AU - S. Person
AU - T. A. Moore Simas
AU - N. Byatt
A1 - 
AB - BACKGROUND: Perinatal depression is common yet undertreated. The Massachusetts Child Psychiatry Access Program (MCPAP) for Moms is a state-wide program to improve access to perinatal depression care by providing training, consultation, and referrals to healthcare professionals serving perinatal women. The PRogram In Support of Moms (PRISM) includes MCPAP for Moms plus practice-level implementation support. This cluster randomized controlled trial compared MCPAP for Moms vs. PRISM in implementation of the perinatal depression care pathway, inclusive of screening, assessment, treatment, follow-up and monitoring, and transition of care. METHODS: Ten obstetric practices were randomized to MCPAP for Moms or PRISM. We abstracted medical record data for perinatal individuals enrolled in the study with elevated depression symptoms (n = 294). Generalized linear mixed-effects models, accounting for clustering of practices, compared post-intervention implementation of the depression care pathway. We also examined changes in implementation via practice leadership surveys. RESULTS: Patients in PRISM practices were more likely to be screened for bipolar disorder (OR = 385.0, p = .001), have treatment engagement documented (OR = 2.8, p = .011), receive follow-up monitoring (OR = 4.0, p = .003), and receive a transition of care plan (OR = 2.7, p = .016). Patients in PRISM practices were more likely to be identified as having perinatal depression (OR = 2.3, p = .001). Practice leadership reported greater increase in capacity to address perinatal depression in PRISM practices (3.7 points, p = .005). CONCLUSIONS: PRISM was associated with greater depression care pathway implementation and improved identification of patients with perinatal depression. In order to help implement new initiatives (i.e. bipolar disorder screening) aligned with the depression care pathway, practice-level assistance may be needed.
AD - Department of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Martha.Zimmermann1@UMassMed.edu.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address: gmasters@mgh.harvard.edu.; Department of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Padma.Sankaran@UMassMed.edu.; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Julie.Flahive@UMassMed.edu.; Department of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Radley.Sheldrick@UMassMed.edu.; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Jeroan.Allison@UMassMed.edu.; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America. Electronic address: Sharina.Person@UMassMed.edu.; Department of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; Department of Pediatrics, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; UMass Memorial Health, Worcester, MA, United States of America. Electronic address: TiffanyA.MooreSimas@UmassMemorial.org.; Department of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA, 01655, United States of America; UMass Memorial Health, Worcester, MA, United States of America. Electronic address: Nancy.Byatt@UMassMemorial.org.
AN - 41485510
BT - J Affect Disord
C5 - Healthcare Disparities; Education & Workforce
DA - Apr 15
DO - 10.1016/j.jad.2025.121124
DP - NLM
ET - 20260102
JF - J Affect Disord
LA - eng
N2 - BACKGROUND: Perinatal depression is common yet undertreated. The Massachusetts Child Psychiatry Access Program (MCPAP) for Moms is a state-wide program to improve access to perinatal depression care by providing training, consultation, and referrals to healthcare professionals serving perinatal women. The PRogram In Support of Moms (PRISM) includes MCPAP for Moms plus practice-level implementation support. This cluster randomized controlled trial compared MCPAP for Moms vs. PRISM in implementation of the perinatal depression care pathway, inclusive of screening, assessment, treatment, follow-up and monitoring, and transition of care. METHODS: Ten obstetric practices were randomized to MCPAP for Moms or PRISM. We abstracted medical record data for perinatal individuals enrolled in the study with elevated depression symptoms (n = 294). Generalized linear mixed-effects models, accounting for clustering of practices, compared post-intervention implementation of the depression care pathway. We also examined changes in implementation via practice leadership surveys. RESULTS: Patients in PRISM practices were more likely to be screened for bipolar disorder (OR = 385.0, p = .001), have treatment engagement documented (OR = 2.8, p = .011), receive follow-up monitoring (OR = 4.0, p = .003), and receive a transition of care plan (OR = 2.7, p = .016). Patients in PRISM practices were more likely to be identified as having perinatal depression (OR = 2.3, p = .001). Practice leadership reported greater increase in capacity to address perinatal depression in PRISM practices (3.7 points, p = .005). CONCLUSIONS: PRISM was associated with greater depression care pathway implementation and improved identification of patients with perinatal depression. In order to help implement new initiatives (i.e. bipolar disorder screening) aligned with the depression care pathway, practice-level assistance may be needed.
PY - 2026
SN - 0165-0327
SP - 121124
ST - The PRogram In Support of Moms (PRISM): Increasing obstetric practice capacity to implement the depression care pathway
T1 - The PRogram In Support of Moms (PRISM): Increasing obstetric practice capacity to implement the depression care pathway
T2 - J Affect Disord
TI - The PRogram In Support of Moms (PRISM): Increasing obstetric practice capacity to implement the depression care pathway
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1016/j.jad.2025.121124
VL - 399
VO - 0165-0327
Y1 - 2026
ER -