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A mixed-methods study protocol: Perinatal depression screening systems and outcomes in obstetrics clinics
Rachel Vanderkruik1,2, Marlene P Freeman1,2, Margaret Gaw1
1Massachusetts General Hospital, Ammon-Pinizzotto Center for Women's Mental Health, Boston, Massachusetts, United States of America.
Insights
Perinatal depression (PND) screening and referral processes are not well understood in clinical settings. This study examines how PND is managed in obstetrics clinics to identify system improvements for better patient outcomes.
Area of Science:
- Perinatal mental health
- Implementation science
- Public health
Background:
- Perinatal depression (PND) is a significant public health concern with lasting effects on parents and children.
- Existing evidence-based screening tools for PND are underutilized in clinical practice.
- There is a lack of data on the implementation of PND screening and referral processes in real-world settings.
Purpose of the Study:
- To characterize PND screening and referral procedures within obstetrics clinics.
- To identify system-level improvements for managing PND.
- To inform future research on hybrid-implementation effectiveness for PND.
Main Methods:
- Observational study protocol guided by implementation science frameworks.
- Mixed-methods approach integrating qualitative and quantitative data.
- Data sources include electronic health records, patient surveys, and interviews across a large academic medical system.
Main Results:
- The study protocol is designed to capture complex screening and referral practices.
- It aims to identify specific barriers and facilitators to care within the PND management system.
- Findings will provide insights into the role of embedded perinatal social workers.
Conclusions:
- Understanding current PND screening and referral practices is crucial for improving care.
- Implementation science provides a framework for optimizing PND management systems.
- This research will lay the groundwork for improving patient outcomes through enhanced PND care pathways.
Abstract:
Perinatal depression (PND) is an underrecognized and underdiagnosed public health issue with long-term adverse impacts on birthing parents and their children. While obstetrics practices are increasingly encouraged to use existing evidence-based screening tools, there is little data describing the extent to which screening practices and subsequent referrals to care are implemented in clinical settings. The Screening and Treatment Enhancement for Perinatal Depression (STEPS for PPD) study aims to characterize PND screening and referral procedures and identify areas for system improvements. We describe a protocol for an observational study, guided by implementation science frameworks, examining the role of embedded perinatal social workers in managing PND across Mass General Brigham system obstetrics clinics. Our mixed-methods approach integrates qualitative and quantitative data from a variety of sources, including electronic health records, patient-reported surveys, and qualitative interviews, to capture complex screening and referral practices across a large academic medical system. We aim to characterize nuances within the screening and referral system and identify barriers and facilitators to care to inform future hybrid-implementation effectiveness research and improve patient outcomes.
