Facilitating Effective Referrals for Postpartum Depression

产后抑郁症（PPD）是一个重大的心理健康和公共卫生问题。据估计，10-15%的妇女在分娩后患有严重抑郁症。大量研究表明，母亲抑郁会对孩子和母子关系产生负面影响。生活在贫困中的母亲更容易抑郁，更难以获得心理健康服务，因此是一个特别脆弱的群体。各种个人的、实际的和组织上的障碍阻碍了产后母亲利用现有的心理健康治疗。基于社区的参与性研究方法是一种很有前途的战略，可用于制定和实施服务研究，解决低收入、抑郁和产后妇女利用心理健康的障碍，因为它汇集了社区和学术界的专门知识。该申请建议加强费城儿童医院/宾夕法尼亚大学、产科护理联盟（MCC）和社区成员之间的伙伴关系。这一伙伴关系将促进为产后妇女及其家庭提供精神卫生服务的合作研究。它还将涉及提高世纪挑战集团的研究能力，召集一个社区咨询委员会，以及规划可持续性和传播。研究计划包括设计一个转诊干预措施，以促进成功转诊到心理健康治疗，将在公开试验中进行可行性和可接受性测试。转诊干预将采用手动方式，包括各种策略和模块（如心理教育、解决问题、后续行动），以促进心理健康的利用。这项试点工作将作为R01申请的基础，在该社区进行比较转诊干预与常规转诊策略的随机试验。

DESCRIPTION (provided by applicant): Project Summary Postpartum depression (PPD) is a significant mental health and public health problem. It is estimated that 10-15% of women suffer from major depression after childbirth. Considerable research has shown the negative impact of maternal depression on children and mother-child relationships. Mothers living in poverty are more likely to be depressed and have greater difficulty accessing mental health service, and therefore are a particularly vulnerable group. A variety of personal, practical, and organizational barriers hinder postpartum mothers from utilizing available mental health treatment. A community based participatory research approach is a promising strategy for developing and implementing services research addressing barriers to mental health utilization for low-income, depressed, postpartum women because it brings together the expertise from the community and academia. This application proposes strengthening a partnership between the Children's Hospital of Philadelphia/University of Pennsylvania, Maternity Care Coalition (MCC), and community members. This partnership will foster collaborative mental health services research for postpartum women and their families. It will also involve improving MCC's research capacity, convening a community advisory board, and planning for sustainability and dissemination. The research plan involves designing a referral intervention to facilitate successful referrals to mental health treatment that will be tested in open trial for feasibility and acceptability. The referral intervention will be manualized and consist of strategies and modules (e.g., psychoeducation, problem solving, follow-up) to facilitate mental health utilization. This pilot work will be used as a foundation for a R01 application to conduct a randomized trial in this community comparing the referral intervention to routine referral strategies. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE This project proposes strengthening a community-academic partnership to address access to mental health treatment by postpartum, low-income, depressed women. We will build the research capacity of the community organization and collaborate in developing and providing a preliminary test of a brief referral intervention that focuses on personal and organizational barriers that keep depressed postpartum women from accessing mental health services. Given the prevalence of depression in mothers, its impact on children and costs to society, the development of empirically based strategies to increase mental health use will be an important contribution to improving maternal and child outcomes.