Addressing Maternal Depression Through Home Visiting: One State's Experience With a Breakthrough Series Collaborative

Area of Science:

• Public Health
• Maternal Health
• Healthcare Quality Improvement

Background:

• A national Breakthrough Series (BTS) collaborative demonstrated success in improving maternal depression outcomes.
• Alabama's First Teacher home visiting program sought to replicate these improvements through a state-led BTS.

Purpose of the Study:

• To assess the impact of a state-led Breakthrough Series (BTS) collaborative on maternal depression outcomes in Alabama's home visiting program.
• To evaluate the effectiveness of evidence- and experience-based practices in improving maternal depression screening, referrals, and service access.

Main Methods:

• Eight local implementing agencies (LIAs) participated in the state-led BTS, serving over 500 families.
• Agencies used Plan-Do-Study-Act cycles to test changes and tracked data on depression screening, referrals, service access, and symptom improvement.
• A post-collaborative survey assessed LIA team members' satisfaction with the BTS experience.

Main Results:

• The Alabama BTS achieved positive shifts in maternal depression referrals, service access, and symptom improvement.
• Key interventions included a screening script, motivational interviewing, the "Mothers and Babies" program, and a registry.
• Participating agencies reported that BTS tools enhanced their capacity to address maternal depression.

Conclusions:

• Evidence- and experience-based practices implemented through a state-based home visiting program can effectively improve maternal depression outcomes.
• The study corroborates previous findings and includes valuable feedback from LIAs on the BTS process.