| Description |
BackgroundPostpartum depression affects one in nine women in the United States. Signs and symptoms of postpartum depression vary greatly, from sadness and irritability to over or under-eating. Young mothers, single mothers, mothers of low socioeconomic status, and minorities are at the highest risk for postpartum depression. The federally-funded program Women, Infants, and Children (WIC) was founded to help low-income women with prenatal care, postpartum care, child wellness exams up to age five, breastfeeding support, and nutritional support. Based on the demographic characteristics of the women WIC serves, including socioeconomic status and race, women who participate in WIC are at high risk for postpartum depression.MethodsThe purpose of this project is to increase the rates of postpartum depression screening and referral by Utah County WIC clinicians through the development and implementation of a training module. The first objective of this project was to assess the current rates and methods of postpartum depression screening and referrals in the Utah County WIC offices, as well as the current knowledge and confidence of WIC clinicians regarding postpartum depression and evidence-based screening processes. An in-person training module for WIC clinicians about evidence-based, best practices for screening and referral for postpartum depression was developed and implemented at the Utah County WIC Annual Meeting. Finally, the effect of training on rates of postpartum depression screening in Utah County WIC offices and on the confidence and knowledge of WIC clinicians was evaluated.ResultsResults from the pre-survey showed an initial lack of basic knowledge regarding postpartum depression and a lack of confidence and comfort among WIC clinicians to discuss, let alone screen for, it. The post-survey showed a statistically significant improvement in all areas, including basic knowledge, a 25% (TS=47,<T=107) increase in confidence discussing postpartum depression, and an increase of 13% (TS=17, <T=107 in the comfort of clinicians in screening for postpartum depression. Chart reviews from November 2018 did show screening for postpartum depression, but with no documentation of a screening tool. In November 2019, postpartum depression screening was improved by 15% (p= 0.0409), while referrals to the outside resources presented at the training increased by 50% (p=0.248), though this was not statistically significant. Although this all suggests improvement, only one (5%) documentation of the PHQ-2 screening tool was identified in the November 2019 chart reviews after the intervention. ConclusionThis project suggests that increased training of WIC clinicians improves their self-reported confidence in discussing postpartum depression and comfort with screening for it. However, this project was limited to a single training with small participant numbers, and changes in actual WIC clinician screening and referral practices were limited. Continuing education throughout the year and a WIC system change may necessary to encourage clinician use of evidence-based screening and referral tools. |
