| Description |
Background:Paternal Postpartum Depression (PPpD) can have dire long-lasting effects on children's cognitive, behavioral, social, and emotional development yet there is little attention given to the mental health of new fathers. Rates of PPpD have been found to be as high as 35.5% in the United States, with the highest rates three to six months after the birth. Various biopsychosocial factors contribute to men developing PPpD. Risk factors include having a partner experiencing postpartum depression, personal history of depression, perceived stress, and availability of support. There are a variety of available interventions that are underutilized for fathers, most notably is screening for PPpD during well-child visits when the child is between new born and one year old. The goal of this DNP project is to implement a screening and referral protocol in a pediatric clinic setting, increasing knowledge and awareness of paternal postpartum depression for healthcare professionals.Methods: The initial step of this quality improvement project identified pediatric clinic provider's perceived barriers to paternal postpartum screening using a REDcap "Pre-survey." An evidence-based protocol (EBP) was developed and implemented in the pediatric clinic. This protocol included the PHQ-2 and PHQ-9 screening tools, an educational pamphlet covering symptoms, risk factors, resources, and referrals for PPpD, and a workflow algorithm. Prior to initiation, and on-going as needed, providers and staff were educated about PPpD, the EBP protocol, and why screening was relevant in the pediatric clinic setting. PHQ-2 screenings were tracked during weekly clinic visits over the course of this 10-week study. At the conclusion of this 10-week study, providers completed a "Post-survey" to assess the feasibility, usability, and satisfaction of the PPpD protocol. Results: Participating providers (N=3) saw a total of 1743 patients during the 10-weeks, with 253 (14.5%) of those being well-child checks for ages newborn to one-year, and of those 55 (21.7%) screenings were completed. The rate of screening improved as more support staff received education on the postpartum screening protocol, with a 31% increase in screening during the sixth week and a 59% increase during the ninth week. Additionally, although time was seen as a significant barrier to screening parents for depression, providers reported taking six minutes or less to complete the screening, education, and referral. After the conclusion of this project all three providers (100%) agreed that the project addressed the problem, the benefits outweighed the cost and intended to continue using the protocol in the future.Conclusion: The paternal postpartum screening protocol was well received among providers and facilitated conversations about paternal postpartum mental health concerns. Replication of this quality improvement project is needed to determine the impact of PPpD screening on early continue increasing knowledge and awareness of PPpD, provide early intervention for those at risk. |
