Implementing an Edinburgh Postnatal Depression Scale Protocol in an Urban Pediatric Clinic
Nature and scope of the project
When parents have postpartum depression (PPD), children are more likely to have adverse childhood events, anxiety, depression, and school problems. The American Academy of Pediatrics (AAP) recommends screening parents for depression at routine well-child visits as they may not attend their postpartum visit where depression screening is standard of care. Komed Holman Health Center is a Federally Qualified Community Health Center on the south side of Chicago, and there is no current policy in the pediatric department for screening for postpartum depression.
Synthesis and analysis of supporting literature
Postpartum depression is underdiagnosed. Approximately 25% of Illinois women report feeling down, depressed, or hopeless after pregnancy, and rates are higher in low-income minority communities. For Black postpartum patients, 19% of pregnancy related deaths in the first-year post birth are associated with violent death such as homicides, suicides, and drug overdoses. These factors are related to mental health challenges and may be detectable with appropriate, evidence-based screening. In a similar urban setting, researchers educated pediatric clinicians and developed a policy for PPD screening at well child checks which resulted in increased diagnosis and referral for behavioral health care.
Project implementation
The purpose of this project is to implement an evidence-based protocol for postpartum depression screening in Komed Holman Health Center’s pediatric department. Using the Model for Improvement framework’s Plan-Do-Study-Act (PDSA) cycle, clinical staff will be trained on postpartum depression screening and AAP guidelines, and the Edinburgh Postnatal Depression Scale screening tool will be incorporated in the electronic medical record for well-child visits. Implementation of postpartum depression screening will occur at the newborn, 1-, 2-, 4-, 6-, 9-, and 12-months well-child checkups. Parents who screen positive for depressive symptoms will be referred for case management and behavioral healthcare. Data will be collected over 8 weeks.
Evaluation criteria
The staff pre and posttest values will assess change in knowledge following the educational intervention, and t-tests will compare rates of PPD screening prior to and after intervention. The total number of parents referred to case management and behavioral health following a positive screen for depressive symptoms will be compared to pre-intervention data.
Outcomes
the project is in data collection 2/2024-4/2024
Recommendations
the project is in data collection 2/2024-4/2024
Implementing an Edinburgh Postnatal Depression Scale Protocol in an Urban Pediatric Clinic