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Linking MCH and WIC: Integrating perinatal depression screening and prevention for high risk pregnant women
Project Number: R40 MC 17179
Grantee: George Washington University
Project Date: 02/01/2010
Huynh-Nhu (Mimi) Le, Ph.D.
Associate Professor of Psychology
2125 G Street NW
Washington, DC 20052
- Perinatal/Infancy (0-12 months)
Perinatal depression is a significant public health problem, and its negative effects extend beyond women to their children, families, and even society. Although there are identifiable risk factors and effective treatments, few women, especially low-income ethnic minority women, receive screening or treatment during this critical period. Reliable screening tools for perinatal depression are readily available and recommended for use in public health settings, yet screening remains limited in practice, in part due to the lack of coordination of services available to women seeking care during pregnancy and postpartum. As one of several federal programs that serve women and infants across the perinatal period, the Women, Infants, and Children (WIC) program can bridge this gap in screening and preventive services for their low-income populations. This project builds on an 8-year partnership between researchers at George Washington and Georgetown Universities and practitioners from the Mary's Center for Maternal and Child Care, a community-based health clinic serving low-income ethnic minority families. In a previously funded MCHB grant, we conducted a randomized controlled trial to evaluate the effectiveness of an 8-week cognitive-behavioral preventive intervention (i.e., the Mothers and Babies/MB course) delivered during pregnancy, with promising results in reducing depression in low-income Latinas. For this project, we will modify the MB course into an 8-week perinatal curriculum, aimed at reducing depressive symptoms and the onset of major depression for both pregnant and postpartum women. The specific aims are to: (1) Integrate routine screening for perinatal depression in the Mary's Center WIC program; (2) Expand the prenatal MB course and adapt it for both pregnant women and mothers in the first postpartum year (MB course/Perinatal version: MB-P); (3) Evaluate the effectiveness of the MB-P on preventing perinatal depression and improving the health and well-being of women and their infants; and (4) Assess the impact of the MB-P on WIC participation and outcomes up to the first year postpartum. We will conduct a three-year community-based observational study, embedding routine perinatal depression screening for all WIC pregnant and postpartum women with infants <1 year old (n=1,119). In addition, women identified as high-risk from this screening (n=380) will be invited to participate in the MB-P course, to evaluate its effectiveness on reducing perinatal depression and improving health outcomes. An estimated 266 women will agree to participate in the prevention study (intervention: n=146; comparison: n=120). Data on psychological and physical health, utilization, perceived barriers to care, and risk and protective factors for perinatal depression will be collected at baseline, post-intervention, and at 6 months post-intervention. We will also request access to utilization and outcomes data for a usual care group (n=114) who are not interested in participating in the prevention study, but who consent to provide de-identified data from administrative databases maintained by the Mary's Center. The proposed project addresses 3 of the 4 MCHB Strategic Research Issues for MCH populations: I: improve public health systems; II: develop systems of care to eliminate health disparities; and IV: promote the healthy development, as well as the Healthy People 2010 goals for increasing access to mental health services. Lessons learned will have implications for implementing perinatal depression services for low-income, ethnic minority WIC populations.
Listed is descending order by year published.
Perry DF, Le HN, Villamil CA, Yengo J, et al. Integrating perinatal depression screening into WIC at a Federally Qualified Health Center. Prog Community Health Partnersh. 2015;9(2):253-9.
Pooler J, Perry DF, Ghandour RM. Prevalence and risk factors for postpartum depressive symptoms among women enrolled in WIC. Matern Child Health J. 2013. Jan 18. [Epub ahead of print] PubMed PMID: 23329168.
Depression, Perinatal, Mental Health & Wellbeing, Pregnancy, Postpartum, Screening, Health Disparities, Health Care Utilization