Implementing routine assessment of perinatal anxiety: case studies

Area of Science:

• Maternal Health
• Mental Health Services
• Healthcare Implementation Science

Background:

• Perinatal anxiety affects many women, increasing risks for adverse birth and child development outcomes.
• Standardized identification of perinatal anxiety is recommended, yet consensus on effective measures is lacking.
• The Stirling Antenatal Anxiety Scale (SAAS) has shown diagnostic accuracy and acceptability in prior research.

Purpose of the Study:

• To evaluate the acceptability and feasibility of integrating the SAAS into routine healthcare services.
• To identify barriers and facilitators for implementing perinatal anxiety screening tools in clinical practice.

Main Methods:

• Case studies involving implementation of the SAAS across three UK National Health Service (NHS) sites.
• Semistructured interviews and focus groups with healthcare professionals (midwives, health visitors, psychologists, nurses) pre- and post-implementation.
• Framework analysis combined with inductive-deductive approaches for data analysis.

Main Results:

• Implementation was generally perceived positively, enhancing focused conversations about women's anxiety symptoms.
• Key barriers included language differences and cultural stigma; acceptability among healthcare professionals was high.
• Recommendations for improvement included electronic integration of the tool and securing senior management buy-in.

Conclusions:

• The implementation of the SAAS as a new perinatal anxiety measure was positively received overall by healthcare practitioners.
• Addressing barriers like language and stigma, and optimizing integration into electronic health records, can enhance future implementation.
• Further exploration of digital and translated versions is warranted for broader applicability.