Online Training For Addressing Perinatal Depression

项目摘要 该提案的主要目标是开发、实施和评估一个在线模块，以改进产科 提供者关于围产期抑郁症的知识、技能和做法。有一个巨大的公共卫生 需要解决这个问题，因为超过五分之一的妇女患有围产期抑郁症。听之任之， 它对母婴结局、婴儿依恋和儿童的 行为/发展。抑郁症妇女产后死亡中有20%是由产妇自杀引起的。尽管 绝大多数围产期妇女都愿意接受抑郁症筛查，但仅靠筛查不能。 提高治疗率或患者结局。虽然大多数产科提供者报告说想要 解决抑郁、对责任的恐惧、不适以及缺乏知识和资源带来的障碍。 解决这些障碍需要一种实际和可持续的方法。为了满足这一需求，我们的团队 为妈妈们开发了马萨诸塞州儿童精神病学接入项目(MCPAP)。适用于妈妈的MCPAP 为产科提供者提供有关如何发现、评估和治疗围产期抑郁症的培训。我们的培训 已被确定为其他州的典范；来自全国15个不同州的利益攸关方 联系了我们的团队，并索取了我们的培训材料。然而，我们的培训是专门针对 马萨诸塞州环境和可用的心理健康资源，目前是亲自交付的。填满 为了扩大其他州的培训差距，并使培训更容易获得，我们建议制定一种-- ART，培训模块，解决围产期抑郁的基础，将在线提供并采取 考虑到美国其他州提供的不同心理健康资源。该模块将 支持产科提供者：1)实施抑郁症筛查；2)评估抑郁症和合并症；3) 对复杂病例进行分类，并将复杂病例转介给精神科提供者；4)治疗病情不那么复杂的妇女；以及 5)考虑不同治疗模式的风险和收益。我们将对此进行形成性评估 通过与10个产科提供者的深入访谈，并根据反复反馈对其进行修改/改进。我们 然后，将通过与不同的10个产科提供者一起实施该模块来进行总结性评估 A)获取关于供应商知识获取和满意度的数据(测试前/测试后比较)以及 提供者对抑郁症筛查的知识、态度和做法，以及b)提供者 妇女对心理健康治疗启动的变化的感知(测试前/测试后调查)。如果显示为 有效地，我们的培训将帮助产科提供者实施抑郁症筛查并制定流程 当女性抑郁时，他们需要做出适当的反应，从而为女性提供所需的护理。我们的 综合产科和抑郁症护理、成人学习、围产期精神病学和 OB/GYN以及我们与利益相关者建立的关系使我们非常适合实施， 评估和传播我们的培训。如果被证明有效，我们的培训将准备在全国传播。

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.