PRogram In Support of Moms (PRISM): A Pilot Study
Condition: Perinatal Depression
MeSH terms: Depression
Study type: Interventional

Summary: 
      The primary goal of this study is to evaluate the PRogram In Support of Moms (PRISM) that
      aims to improve women's access to and participation in perinatal depression treatment and
      thereby improve depression outcomes
    

Detailed description: 
      Major depressive disorder continues to be the leading cause of disability among women of
      reproductive age and major public health concern. Upwards of 1 in 5 women suffer from
      depression during pregnancy or within a year after giving birth. It has negative effects on
      birth outcomes, infant attachment, behavior and development. Maternal suicide causes 20% of
      postpartum deaths in depressed women. Although the majority of women are amenable to
      depression screening, screening alone does not improve treatment entry or outcome. Despite
      the availability of effective evidence-based treatments and frequent contact with obstetric
      providers, less than one-third of women who screen positive for depression receive treatment.
      Ob/Gyn practices need supports in place to adequately address depression in their patient
      populations. Thus, the Investigators developed a program called "PRogram In Support of Moms"
      (PRISM) that aims to leverage existing roles and resources to target patient, provider, and
      system level barriers to perinatal depression treatment. PRISM aims to improve perinatal
      depression treatment and treatment response rates through: (1) access to psychiatric
      telephone consultation for Ob/Gyn providers; (2) clinic-specific implementation of stepped
      care, including training support and toolkits; and, (3) proactive treatment engagement,
      patient monitoring, and stepped treatment response to depression screening/assessment. Four
      practices were randomly assigned to PRISM versus an active comparison group called MCPAP for
      Moms which is a state-wide telephonic perinatal psychiatry program. The Investigators will
      compare the effectiveness of PRISM vs. MCPAP for Moms to improve depression severity and
      treatment participation in pregnancy through 3 months postpartum among patients.
    

Intervention name(s): PRogram In Support of Moms (PRISM); MCPAP for Moms
Intervention type(s): Behavioral; Behavioral
Intervention description(s): PRISM Intervention Provider and staff training Webinar Delivered in person Engage providers - Registered Nurses (RN) and Patient Care Assistants (PCA) and ensure they attend:
Toolkit Care coordination Psychiatric consultation Implementation support
Engage clinic leaders and staff
Identify leadership group and prepare for change
Assess readiness to implement PRISM
Identify steps to achieve goals
Implement PRISM components into the clinic
Support, encourage and sustain change Office prompts Screening procedures Plus all MCPAP for Moms intervention; MCPAP for Moms Provider and staff training Delivered via web RN and PCA admin staff recommended to attend 30-60 minute presentation on perinatal depression Access to telephonic psychiatric consultation with MCPAP for Moms perinatal psychiatrist for Ob/Gyns Access to one-time face-face evaluation with patient by a MCPAP for Moms psychiatrist for assessment and treatment recommendations for Ob/Gyn provider Access to Provider Toolkit which includes assessment and treatment protocols (available at www.mcpapformoms.org) Resource provision/referrals
Other intervention name(s): Rapid Access to Perinatal Psychiatric care in Depression; RAPPID
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Depression; Pregnancy; Postpartum