Online Screening and Referral for Postpartum Depression: An Exploratory Study
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The fear and stigma associated with postpartum depression (PPD) is a major challenge in the treatment of this disease. Our goal is to develop innovative methods of screening women for the symptoms of PPD to facilitate referral and treatment. This study explores the efficacy of the Internet in reaching out to postpartum women in the convenience and privacy of their own homes, particularly those in rural and underserved areas. An exploratory study design was used to explore the feasibility and acceptability of online screening for PPD with postpartum women in the first 2–3 months after delivery (N = 18). In the first phase, a focus group was conducted with a small group of postpartum women; the second phase consisted of individual interviews of postpartum women in their homes; and in phase three, 10 women participated in the on-line screening intervention. PPD was measured using an online version of the Edinburgh Postnatal Depression Scale (EPDS) a well-established instrument with reported alpha reliabilities (0.81–0.88) across studies and concurrent validity demonstrated using the gold standard, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for depression interview. Qualitative data collected from all the participants were also analyzed. The sample included women age 18–29; 70 % White/Caucasian, 50 % low income, and the majority living in rural areas. The EPDS scores ranged from 0 to 13 (mean 8.0; SD 4.76). Participants described the online PPD screening process as easy, straightforward and personalized and provided additional suggestions for improvement.
KeywordsPostpartum depression Internet Screening Referral
NIH-NINR grant P20NR009009, Rural Health Care Research Center, University of Virginia School of Nursing, Postpartum Support International (PSI), Susan Hickman Research Award.
- American Psychiatric Association. (2000). Diagnostic criteria from DSM-IV-TR. Washington, D.C.: The Association.Google Scholar
- Beeghly, M., Weinberg, M. K., Olson, K. L., Kernan, H., Riley, J., & Tronick, E. Z. (2002). Stability and change in level of maternal depressive symptomatology during the first postpartum year. Journal of Affective Disorders, 71(1–3), 169–180. doi: 10.1016/S0165-0327(01)00409-8.PubMedCrossRefGoogle Scholar
- Cox, J. L., & Holden, J. M. (2007). Perinatal mental health: A guide to the Edinburgh Postnatal Depression Scale. Glasgow: Royal College of Psychiatrists.Google Scholar
- Dillman, D., Smyth, J., & Christian, M. (2009). Internet, mail, and mixed-mode surveys: The tailored design method (3rd ed.). Hoboken, NJ: Wiley.Google Scholar
- Drake, E., & Coolidge, G. (2010). Postpartum depression: Don’t let patients suffer in silence. American Nurse Today, 5(12), 1–5.Google Scholar
- England, M., & Sim, L. (2009). Depression in parents, parenting, and children: Opportunities to improve identification, treatment, and prevention. The National Academies Press. Retrieved from http://www.nap.edu/catalog.php?record_id=12565.
- Gaynes, B., Gavin, N., Melzer-Brody, S., Lohr, K., Swinson, T., Gartlehner, G., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
- Marcus, S. M. (2009). Depression during pregnancy: Rates, risks and consequences—Motherisk update 2008. Canadian Journal of Clinical Pharmacology/Journal Canadien De Pharmacologie Clinique, 16(1), e15–e22.Google Scholar