Do Patient Characteristics, Prenatal Care Setting, and Method of Payment Matter When it Comes to Provider-Patient Conversations on Perinatal Mood?
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To examine factors associated with provider-patient conversations regarding prenatal and postpartum depressed mood. This study included 3,597 White, African American, Hispanic, and Asian/Pacific Islander NYC resident women who completed the Pregnancy Risk Assessment Monitoring System (PRAMS) survey from 2004–2007, a population-based assessment of patient and health care characteristics. Social determinants including race, nativity, maternal age, prenatal health care setting, and payment type were associated with patient report of having had a conversation about perinatal mood with their provider. Compared to Whites, Asian/Pacific Islanders were less likely to have this conversation (OR = 0.7, CI = 0.5–0.9). Older (OR = 0.6, CI = 0.4–0.9), non-US born (OR = 0.6, CI = 0.5–0.8), and women receiving care from a private doctor or HMO clinic (OR = 0.7, CI = 0.6–0.9) were less likely to have this conversation compared to their respective counterparts. Those who paid for their prenatal care primarily through personal income or through an expanded Medicaid program for prenatal care compared to those who did not were more likely to have had a conversation about mood with their providers. Health care providers and public health advocates should be aware that non-US born women were less likely to have conversations about mood than US born women. However, young mothers shown to be at risk for perinatal depression were more likely to have these conversations compared to older women. Protocols for assessing and educating patients about perinatal mood should be evaluated to improve conversation rates for those receiving care through private doctors and managed care organizations. Income and prenatal care assistance funds may play separate and important roles in provider-patient conversations.
KeywordsSocial determinants Postpartum depression Prenatal care Racial disparities Health care settings
The authors would like to acknowledge the NYC Department of Health and Mental Hygiene Bureau of Maternal, Infant and Reproductive Health PRAMS Team, Bureau of Vital Statistics, and the CDC PRAMS Team, Program Services and Development Branch, Division of Reproductive Health. Support during the preparation of this manuscript was provided through a grant from the Sackler Foundation for Psychobiological Research and through the Stuart T. Hauser Clinical Research Training Fellowship (2T32MH016259-30).
- 1.Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1):1071–1083. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16260528.
- 2.The Postpartum Depression Law. (2006). New Jersey.Google Scholar
- 3.At Act Relative to Postpartum Depression. (2010). Massachusetts. Available from: http://www.mahouse.gov/Laws/SessionLaws/Acts/2010/Chapter313.
- 4.Joseph, G. F. (2009). Transitions. Obstetrics and Gynecology, 1144–1146.Google Scholar
- 5.Perinatal and Postpartum Depression a Top Priority at Annual Conference of Ob-Gyns. (2010). The American congress of obstetricians and gynecologists. Available from: http://www.acog.org/from_home/publications/press_releases/nr05-17-10-2.cfm?utm_source=twitterfeed&utm_medium=twitter.
- 7.Gaynes, B. N., Gavin, N., & Meltzer-Brody, S. (2005). Perinatal depression: prevalence, screening accuracy, and screening outcomes. Rockville Agency for Healthcare Research and Quality.Google Scholar
- 8.Garg, A., Morton, S., & Heneghan, A. (2005). A hospital survey of postpartum depression education at the time of delivery. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN/NAACOG, 34(5):587–594 [cited 2010 Dec 29]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16227514.
- 9.Dietrich, A. J., Williams, J. W., Ciotti, M. C., Schulkin, J., Stotland, N., Rost, K., et al. (2003). Depression care attitudes and practices of newer obstetrician-gynecologists: a national survey. American Journal of Obstetrics and Gynecology, 189(1):267–273. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12861173.Google Scholar
- 10.Segre, L. S., Brock, R. L., O’Hara, M. W., Gorman, L. L., & Engeldinger, J. (2010). Disseminating perinatal depression screening as a public health initiative: A train-the-trainer approach. Maternal and Child Health Journal. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20640494.
- 11.Liu, C. H., & Tronick, E. Rates and predictors of postpartum depression by race and ethnicity: Results from the 2004–2007 New York City PRAMS survey (pregnancy risk assessment monitoring system).Google Scholar
- 12.Howell, E. A., Mora, P. A., Horowitz, C. R., & Leventhal, H. (2005). Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Race, 105(6), 1442–1450.Google Scholar
- 13.Wei, G., Greaver, L. B., Marson, S. M., Herndon, C. H., & Rogers, J. (2008). Postpartum depression: Racial differences and ethnic disparities in a tri-racial and bi-ethnic population. Maternal and Child Health Journal, 12(6):699–707. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17955356.
- 14.Beeghly, M., Olson, K. L., Weinberg, M. K., Pierre, S. C., Downey, N., & Tronick, E. Z. (2003). Prevalence, stability, and socio-demographic correlates of depressive symptoms in black mothers during the first 18 months postpartum. Maternal and Child Health Journal Health, 7(3).Google Scholar
- 15.Rich-Edwards, J., Kleinman, K., Abrams, A., Harlow, B., McLaughlin, T., Joffe, H., et al. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227.PubMedCrossRefGoogle Scholar
- 17.Ricci, S. S., & Kyle, T. (2009). Maternity and pediatric nursing. Philadelphia: Lippincott Williams, & Wilkins.Google Scholar
- 19.Thorburn, S., & De Marco, M. (2010). Insurance-based discrimination during prenatal care, labor, and delivery: perceptions of Oregon mothers. Maternal and Child Health Journal, 14(6):875–85 [cited 2010 Dec 29]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19882241.
- 21.Koleva, H., Stuart, S, O’Hara, M. W., & Bowman-Reif, J. (2010). Risk factors for depressive symptoms during pregnancy. Archives of Women S Mental Health, (1986) [cited 2010 Dec 29]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20872153.
- 22.Mayberry, L. J., Horowitz, J. A., & Declercq, E. (2007). Depression symptom prevalence and demographic risk factors among US women during the first 2 years postpartum. Journal of Obstetric Gynecologic and Neonatal Nursing JOGNN NAACOG, 36(6):542–549. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17973697.Google Scholar
- 23.Fortner, R. T., Pekow, P., Dole, N., Markenson, G., & Chasan-Taber, L. (2010). Risk factors for prenatal depressive symptoms among hispanic women. Maternal and Child Health Journal, 1–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20824918.
- 24.Segre, L., O’Hara, M., & Losch, M. (2006). Race/ethnicity and perinatal depressed mood. Journal of Reproductive and Infant Psychology, 24(2):99–106. Available from: http://www.informaworld.com/openurl?genre=article&doi=10.1080/02646830600643908&magic=crossref.Google Scholar
- 27.Teng, L., Robertson Blackmore, E., & Stewart, D. E. (2007). Healthcare worker’s perceptions of barriers to care by immigrant women with postpartum depression: An exploratory qualitative study. Archives Of Womens Mental Health, 10(3):93–101. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17497307.
- 28.Park, S. -Y., & Bernstein, K. S. (2008). Depression and Korean American immigrants. Archives of Psychiatric Nursing, 22(1):12–19. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18207052.
- 32.Kumar, R. (1994). Postnatal mental illness: a transcultural perspective. Social Psychiatry and Psychiatric Epidemiology, 29(6):250–264. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7825036.
- 33.Applewhite, S., Perez, M., Simons, H., Wagner, J. S., Putnam, S., & Karpati, A. (2009). Identifying and treating perinatal depression: Views of Brooklyn Healthcare Providers. New York: Department of Health and Mental Hygiene.Google Scholar
- 35.Leong, F. T., & Lau, A. S. (2001). Barriers to providing effective mental health services to Asian Americans. Mental Health Services Research, 3(4):201–214. Available from: http://springerlink.metapress.com/openurl.asp?genre=article&id, doi: 10.1023/A:1013177014788.
- 38.CDC. (2008). 10 leading causes of deaths, United States, 2005. Atlanta.Google Scholar
- 39.Kshetri, N. (2007). Barriers to e-commerce and competitive business models in developing countries: A case study. Electronic Commerce Research and Applications, 6(4):443–452. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1567422307000105.
- 40.Efendioglu, A. M., & Yip, V. F. (2004). Chinese culture and e-commerce: an exploratory study. Interacting with Computers, 16(1):45–62. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0953543803001073.
- 41.Citizen’s committee for children of New York Inc. Risks to child well-being by ethnicity: 2007 and 2008. New York City. Available from: http://www.cccnewyork.org/WebGraphics/KT10/risksbyethnicity.pdf.
- 42.National Latina Institute for Reproductive Health. (2005). Prenatal care access among immigrant Latinas. New York City. Available from: http://latinainstitute.org/sites/default/files/publications/PrenatalCare-2_0.pdf.