| Description |
Background: Paternal postpartum depression (paternal PPD) or paternal major depressive disorder with peripartum onset is an under-researched and under-identified disorder. Approximately 8-14% of fathers will present with new symptoms of depression in the peripartum period, which ranges from the first trimester to 12 months after the child's birth. An inadequate quantity of resources is available for patients and providers to help recognize and manage the disorder. Local Problem: Utah has a higher prevalence of both major depressive disorder and maternal postpartum depression disorder compared to the national average. The Utah Department of Health and Human Services has identified symptoms of a previous mental illness, elevated ACE scores, and co-occurring chronic illnesses as factors among those in Utah diagnosed with depression. These symptoms are associated with risk factors for the likelihood of a diagnosis of maternal postpartum depression. Methods: A quality improvement initiative was developed to improve participants' confidence and knowledge in identifying and diagnosing paternal postpartum depression. Participants included one psychiatric mental health nurse practitioner, one physician assistant, and four therapists. All six agreed to participate in the initiative. Participants completed a pre-intervention questionnaire to assess current knowledge, beliefs, screening practices, and confidence levels in recognizing, screening, and diagnosing paternal postpartum depression. Educational resources were developed and provided to participants, including an educational presentation and toolkit titled "Uplifting Fatherhood," with resources to help identify the disorder and online resources for referring and supporting patients. Post-presentation questionnaires were administered to participants to determine satisfaction with the education and willingness to use the toolkit. The participants in clinical practice implemented the toolkit for 12 weeks, and the distribution of the toolkit was monitored. Participants were provided a post-intervention questionnaire to determine changes in screening methods, number of toolkits distributed, changes in confidence, barriers and improvements to the initiative, and feasibility, usability, and satisfaction. Intervention: Participants received an evidenced-based toolkit and education on paternal postpartum depression and implemented the toolkit into practice for 12 weeks. During the intervention period, the PDSA cycles were implemented to facilitate concurrent improvement and uptake of the toolkit. The number of toolkits distributed was tallied by participants during and at the end of the intervention period. Results: Post-intervention, all six (n= 100%) participants agreed they gained the knowledge and training to identify the disorder and can make an accurate paternal PPD diagnosis. There was a slight increase in patient screenings and the use of the Edinburgh Postnatal Depression Scale (EPDS). All six (n=100%) participants believed the toolkit was simple to integrate into their practice and agreed to continue implementing it in the future. Participants identified the need for a physical handout or a QR code to provide the toolkit to their patients. Conclusion: The development and implementation of the Uplifting Fatherhood toolkit and educational presentation improved participants' collective confidence in identifying, screening, and diagnosing paternal postpartum depression. Improving the data collection method for the distribution will be crucial for improving the replication of this initiative. Other disciplines, such as family medicine, pediatrics, and obstetrics, may be areas where a paternal postpartum depression toolkit may be useful to implement. |
