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Technology-Enabled Service for Perinatal Depression

Perinatal depression (PD) affects one in seven women. Untreated PD can have devastating consequences, including pregnancy-associated suicide, which has remained among the leading contributors to maternal mortality in the United States. Collaborative care (CC) has been shown in randomized trials to improve PD outcomes. However, a major challenge in the implementation of postpartum collaborative care is the overburdened role of the care manager (CM), the lynchpin of the collaborative care model. CMs are managing many more patients than recommended targets. Additionally, the unique context of the postpartum period, including newly competing priorities when managing demands of newborn care, often requires multiple outreach attempts by the CM to promote engagement. Due to these challenges, CMs are only able to complete the core CC tasks for women with critical mental health needs, leaving most women without the active management of care or brief behavioral interventions needed to achieve remission of depression.

Technology-enabled services (TES), which use web-based and mobile application supported by low-intensity coaching or care-management, represent a novel solution that would enable the CMs to more efficiently and effectively adhere to the core tenants of CC that have been demonstrated to improve depression outcomes. This research project will use a comprehensive user centered design approach to engage patients, care managers and physicians in the design of a TES — comprised of technologies, CM service protocol and implementation plan — that can be successfully deployed in a perinatal collaborative care program. The overall TES will be designed to support the existing collaborative care model, facilitating the acquisition of ongoing depression symptom tracking from patients and improving communication with patients, both critical to informing the stepped care processes. The design innovation focus of this research project will be to design a CM dashboard that will help organize the CM workflow, promote patient engagement, facilitate communication and automate tasks. We will leverage ongoing research efforts in our center developing CM dashboards that help CMs better organize their work. Patient-facing tools will focus on completing psychological assessments and receiving feedback. The effectiveness and implementation of the developed TES will be evaluated in a randomized trial across five obstetric clinics. This project has the potential to create and assess implementation the first fully functional TES for perinatal collaborative care.  

The PI is Emily S. Miller, MD, MPH and the Co-I is Madhu Reddy, PhD, FACMI.


Open-Access IRB Materials

To promote research on digital mental health and technology-enabled-services, we have made IRB materials related to this project freely accessible on our IRB Document Repository. Investigators may adapt or reference these materials when forming their own IRB submissions for projects related to digital mental health. 

Project Name

  • Technology-Enabled Services for Postpartum Depression

Funding

  • National Institute of Mental Health, Grant Number: P50 MH119029

 

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