Evaluation of a Telehealth Intervention for Postpartum Depression

Purpose. This project investigated the effectiveness of using a computer-based telehealth platform in order to facilitate early recognition and initiation of interventions for postpartum depression (PPD). The purpose of this project was to increase awareness and prevention of postnatal depression through an educational intervention targeting women at high risk for PPD. The project also sought to evaluate the potential to decrease visit and transportation costs to patients using a virtual approach. Methods. Project interventions were structured around the Precaution Adoption Process Model (PAPM), which is based on changing patient health behaviors. This model assisted in evaluating patient knowledge regarding PPD and provided and guided interventions and future expectations for the primary care provider. Potential participants were drawn from a pool of patients flagged as high risk for depression after completing the mEVAL©, an electronic depression screening tool that uses the Edinburgh Postnatal Depression Scale (EPDS), throughout the University of Utah Health Care (UUHC) network. Participants who consented to participate were scheduled for a 60-minute PPD educational session within 12 weeks following a live birth. Sessions were conducted by a registered nurse. Sessions also included a resource list of mental health providers within their network and self-care strategies to reduce depression symptoms. A follow up EPDS was emailed to patients two weeks later. They were invited to participate in a video platform focus group one month later to determine perceived benefits and satisfaction with the content and delivery method of the intervention and to gather feedback for program improvements. Results. Pre- and post-intervention EPDS scores were compared to assess efficacy of the intervention. Post-intervention EPDS scores were found to be considerably improved following the telehealth educational intervention, with a mean EPDS score reduction of 3.38. A Wilcoxon signed rank test was used with a significance level (p < 0.05) and corresponding confidence interval of 95% and showed a significant difference in pre- and post-intervention scores (p=.001). Participants reported satisfaction with the telehealth model of PPD education delivery and valued its lower cost and convenience. Conclusion. This educational intervention was successful in reducing depressive symptoms reported by women in the study during the first 12 weeks of the postpartum period. Telehealth delivery of the PPD intervention was both feasible and acceptable to patients. These virtual visits reduced time and cost burden to patients. More research needs to be conducted with larger numbers of women in various settings.