Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services

Price, Sarah Kye; Coles, D. Crystal; Wingold, Tracey

doi:10.1093/hsw/hlx037

Cited by 16 publications

(16 citation statements)

References 23 publications

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“…Most studies were RCTs (n = 10) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] or observational studies (n = 7). [40][41][42][43][44][45][46] The remainder of the study designs and quality ratings for all articles are detailed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…44,53,54 Settings were both private and public and included private obstetric offices (n = 2), 39,43 public clinics and hospitals (n = 4), 35,49,50,55 federally qualified health centers (n = 3), 45,46,51 Infant, and Children (WIC) sites (n = 1), 45 academic settings (n = 7), [25][26][27][28][29][30]49 and community settings (n = 4). 43,45,46,54 Studies were conducted in the United States (n = 17), [25][26][27][28][29][30][31][32][33][34][35]39,[41][42][43]45,46,48,49,51,52,55 Australia (n = 4), 36,44,50,…”

Section: Settingsmentioning

confidence: 99%

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Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

et al. 2021

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Introduction: Health is impacted by a wide range of nonmedical factors, collectively termed the social determinants of health (SDoH). As the mechanisms by which these factors influence wellness and disease continue to be uncovered, health systems are beginning to assess their roles in addressing patient's social needs. This study seeks to identify and analyze clinic-based interventions aimed at addressing patients' social needs in perinatal care, including prenatal, antepartum, and postpartum care. Methods: We conducted a search of six databases through May 2020 for articles describing screening or intervention activities addressing social needs in at least one SDoH domain as defined by Healthy People 2020. We required that studies include pregnant or postpartum women and be based in a clinical setting. Results: Thirty-one publications describing 26 unique studies were identified. Most studies were either randomized-controlled trials (n = 10) or observational studies (n = 7) and study settings were both public and private. The mean age of women ranged from 17.4 to 34.1 years. Most studies addressed intimate partner violence (n = 19). The next most common need addressed was social support (n = 5), followed by food insecurity (n = 3), and housing (n = 2). Types of interventions varied from simple screening to ongoing counseling and case management. There was wide heterogeneity in outcomes investigated. Most IPV interventions that included counseling or ongoing support resulted in reduced IPV recurrence and severity. No intervention with only screening showed a reduction in rate of IPV. Conclusion: This systematic review shines light on several avenues to support pregnant and postpartum women through interventions that embed acknowledgment of social needs and actions addressing these needs into the clinical environment. The results of this review suggest that interventions with counseling or ongoing support may show promise in alleviating social risk factors and improving some clinical outcomes. However, the strength of this evidence is limited by the paucity of studies. More rigorous research is imperative to augment the knowledge of social needs interventions, especially in domains outside of IPV.

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Section: Resultsmentioning

confidence: 99%

Section: Settingsmentioning

confidence: 99%

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

et al. 2021

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“…Women's preferences for the type of service offered also influenced the level of acceptance. The literature suggests that many women prefer home visitation to specialized services and that some women tended to use their own resources instead of professional care [32,33,42,43]. We are currently conducting qualitative research to explore in depth the causes behind this observation in China.…”

Section: Discussionmentioning

confidence: 99%

Chinese Women’s Acceptance and Uptake of Referral after Screening for Perinatal Depression

Gong

Jin

Cheng

et al. 2020

IJERPH

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China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China.

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“…Among the different methods of referral, on-site assessment or treatment appeared to be more effective. Previous studies have shown that women who received referrals to the same site as their prenatal or postnatal care were more likely than those referred offsite (Smith et al ., 2009 ; Flynn et al ., 2010 ; Price et al ., 2017 ). Access to further assessments and treatment on-site is more convenient and would reduce the degree of stigma and therefore more acceptable to women.…”

Section: Discussionmentioning

confidence: 99%

Uptake of referrals for women with positive perinatal depression screening results and the effectiveness of interventions to increase uptake: a systematic review and meta-analysis

Xue

Cheng

et al. 2020

Epidemiol Psychiatr Sci

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Aims Perinatal depression threatens the health of maternal women and their offspring. Although screening programs for perinatal depression exist, non-uptake of referral to further mental health care after screening reduces the utility of these programs. Uptake rates among women with positive screening varied widely across studies and little is known about how to improve the uptake rate. This study aimed to systematically review the available evidence on uptake rates, estimate the pooled rate, identify interventions to improve uptake of referral and explore the effectiveness of those interventions. Methods This systematic review has been registered in PROSPERO (registration number: CRD42019138095). We searched Pubmed, Web of Science, Cochrane Library, Ovid, Embase, CNKI, Wanfang Database and VIP Databases from database inception to January 13, 2019 and scanned reference lists of relevant researches for studies published in English or Chinese. Studies providing information on uptake rate and/or effectiveness of interventions on uptake of referral were eligible for inclusion. Studies were excluded if they did not report the details of the referral process or did not provide exact uptake rate. Data provided by observational studies and quasi-experimental studies were used to estimate the pooled uptake rate through meta-analysis. We also performed meta-regression and subgroup analyses to explore the potential source of heterogeneity. To evaluate the effectiveness of interventions, we conducted descriptive analyses instead of meta-analyses since there was only one randomised controlled trial (RCT). Results Of 2302 records identified, 41 studies were eligible for inclusion, including 39 observational studies (n = 9337), one quasi-experimental study (n = 43) and one RCT (n = 555). All but two studies were conducted in high-income countries. The uptake rates reported by included studies varied widely and the pooled uptake rate of referral was 43% (95% confidence intervals [CI] 35–50%) by a random-effect model. Meta-regression and subgroup analyses both showed that referral to on-site assessment or treatment (60%, 95% CI 51–69%) had a significantly higher uptake rate than referral to mental health service (32%, 95% CI 23–41%) (odds ratio 1.31, 95% CI 1.13–1.52). The included RCT showed that the referral intervention significantly improved the uptake rate (p ＜ 0.01). Conclusions Almost three-fifths of women with positive screening results do not take up the referral offers after perinatal depression screening. Referral to on-site assessment and treatment may improve uptake of referral, but the quality of evidence on interventions to increase uptake was weak. More robust studies are needed, especially in low-and middle-income countries.

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Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services

Cited by 16 publications

References 23 publications

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

Chinese Women’s Acceptance and Uptake of Referral after Screening for Perinatal Depression

Uptake of referrals for women with positive perinatal depression screening results and the effectiveness of interventions to increase uptake: a systematic review and meta-analysis

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