Implementing mental health interventions within a national nurse home visiting program: A mixed-methods evaluation

Area of Science:

• Public Health
• Implementation Science
• Maternal Mental Health

Background:

• Maternal depression and anxiety affect up to 50% of low-income mothers, impacting maternal well-being and child development.
• The Mental Health Innovation (MHI) strategy integrates evidence-based mental health interventions into the Nurse-Family Partnership (NFP).
• MHI utilizes online training, clinical resources, team meetings, and virtual consultation.

Purpose of the Study:

• To evaluate the implementation outcomes of the MHI strategy within the NFP program.
• To assess the reach, adoption, acceptability, and feasibility of MHI implementation strategies.

Main Methods:

• A convergent, mixed methods observational design guided by the RE-AIM framework.
• Quantitative data from NFP national data management systems on reach and adoption.
• Qualitative data from focus groups and surveys on stakeholder perceptions of acceptability and feasibility.

Main Results:

• MHI reached 51,534 low-income mothers, with diverse ethnic representation.
• Adoption rates varied: 60-76% of nurses completed online modules, 27-51% of supervisors used team modules, and 40.9% of teams participated in virtual consultation.
• Qualitative data indicated general acceptability of MHI strategies, with varied feasibility perceptions.

Conclusions:

• The MHI strategy demonstrates strengths and areas for improvement in implementation.
• Further research is necessary to determine the MHI's effectiveness in enhancing maternal mental health outcomes.