Online Training For Addressing Perinatal Depression

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Project Summary The primary goal of this proposal is to develop, implement, and evaluate an online module to improve obstetric providers' knowledge, skills and practices regarding perinatal depression. There is a tremendous public health need for addressing this problem as upwards of 1 in 5 women suffer from perinatal depression. Left untreated, it has deleterious effects on maternal and birth outcomes, infant attachment, and children's behavior/development. Maternal suicide causes 20% of postpartum deaths in depressed women. Although the vast majority of perinatal women are amenable to being screened for depression, screening alone does not improve treatment rates or patient outcomes. While the majority of obstetric providers report wanting to address depression, fear of liability, discomfort, and lack of knowledge and resources present barriers. Addressing these barriers requires a practical and sustainable approach. To meet this need, our team developed the Massachusetts Child Psychiatry Access Project (MCPAP) for Moms. MCPAP for Moms provides training for obstetric providers on how to detect, assess and treat perinatal depression. Our training has been identified as a model for other states; stakeholders from 15 different states across the country have contacted our team and requested our training materials. However, our training was developed specific to the Massachusetts environment and available mental health resources and is currently delivered in person. To fill training gaps in other states and make training more broadly accessible, we propose to develop a state-of-the- art, training module, The Basics of Addressing Perinatal Depression, which will be delivered online and take into account the different mental health resources available in other states across the US. The module will support obstetric providers to: 1) implement depression screening; 2) assess depression and comorbidities; 3) triage and refer complicated cases to psychiatric providers; 4) treat women with less complicated illness; and 5) consider risks and benefits of different treatment modalities. We will conduct a formative evaluation of this module via in depth interviews with 10 obstetric providers and revise/refine based on iterative feedback. We will then conduct a summative evaluation by implementing the module with a different 10 obstetric providers by a) obtaining data on provider knowledge acquisition and satisfaction (pre/post-test comparison) and change in knowledge, attitudes, and practices toward depression screening among providers, and b) providers perception of change in mental health treatment initiation among women (pre/post-test survey). If shown to be effective, our training will help obstetric providers implement depression screening and develop the processes they need to respond appropriately when women are depressed, thus getting women the care they need. Our combined expertise in the integration of obstetric and depression care, adult learning, perinatal psychiatry and Ob/Gyn along with our established relationships with stakeholders make us ideally suited to implement, evaluate and disseminate our training. If proven effective, our training will be poised for national dissemination.