Perinatal e-screening and clinical decision support: the Maternity Case-finding Help Assessment Tool (MatCHAT)

Area of Science:

• Maternal Health
• Digital Health Interventions
• Public Health

Background:

• Primary care clinicians use screening tools for mental health, addiction, and family violence.
• Electronic screening tools offer advantages but lack perinatal context availability.
• Early identification of perinatal mental health and substance use issues is crucial.

Purpose of the Study:

• To assess the acceptability and feasibility of the Maternity Case-finding Help Assessment Tool (MatCHAT).
• MatCHAT aims to provide e-screening and clinical decision support for perinatal women.
• The tool addresses depression, anxiety, substance use, and family violence.

Main Methods:

• Co-design approach and extensive consultation to adapt an existing tool (eCHAT) for maternity settings.
• Quantitative data from MatCHAT screening and qualitative data from midwife interviews were analyzed.
• Five midwives and 20 mothers participated in the implementation study.

Main Results:

• Midwives found MatCHAT useful and acceptable.
• Screening identified substance use (8 mothers), anxiety (5 mothers), and depression (1 mother).
• Contextual barriers significantly impeded the implementation of maternity-specific screening.

Conclusions:

• MatCHAT demonstrates potential for optimizing e-screening and decision support in maternity care.
• Contextual barriers were identified as significant impediments to the tool's use in this study.
• Findings are relevant for policymakers and researchers aiming to improve early identification of perinatal issues.