PRogram In Support of Moms (PRISM): Development and Beta Testing

Nancy Byatt1, Lori Pbert1, Safiyah Hosein1

  • 1Dr. Byatt and Dr. Ziedonis are with the Department of Psychiatry, Dr. Pbert is with the Department of Medicine, Ms. Hosein is a medical student, Dr. Weinreb is with the Department of Medicine and Community Health, and Dr. Allison is with the Department of Quantitative Heath Sciences, all at the University of Massachusetts Medical School, Worcester (e-mail: nancy.byatt@umassmemorial.org ). Dr. Byatt is also with the Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester. Dr. Swartz is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.

Most women with perinatal depression do not receive depression treatment. The authors describe the development and beta testing of a new program, PRogram In Support of Moms (PRISM), to improve treatment of perinatal depression in obstetric practices. A multidisciplinary work group of seven perinatal and behavioral health professionals was convened to design, refine, and beta-test PRISM in an obstetric practice. Iterative feedback and problem solving facilitated development of PRISM components, which include provider training and a toolkit, screening procedures, implementation assistance, and access to immediate psychiatric consultation. Beta testing with 50 patients over two months demonstrated feasibility and suggested that PRISM may improve provider screening rates and self-efficacy to address depression. On the basis of lessons learned, PRISM will be enhanced to integrate proactive patient engagement and monitoring into obstetric practices. PRISM may help overcome patient-, provider-, and system-level barriers to managing perinatal depression in obstetric settings.

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