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Prevention of Perinatal Depression: Improving Intervention Delivery for At-Risk Individuals

NAMHC Concept Clearance

Presenter:

Eve E. Reider, Ph.D.
Division of Services and Intervention Research

Goal:

This FOA seeks to encourage research addressing major gaps identified in the United States Preventive Services Task Force (USPSTF) recommendation statement concerning interventions to prevent perinatal depression. The research scope for this concept includes: 1) strategies for identifying women at risk for perinatal depression; 2) developing and testing tools for selecting those most likely to benefit from preventive interventions; 3) implementing service-ready efficacious preventive interventions that are of appropriate intensity/dose, and are scalable, such that they can be delivered with fidelity by setting providers; and, 4) strategies that can be used to train providers and to support delivery of evidence-based approaches with fidelity across diverse health care and community settings.

Rationale:

Perinatal depression is one of the most common complications of pregnancy and the postpartum period. It affects as many as 1 in 7 pregnant women and can result in negative short- and long-term consequences for mother and baby (Gavin et al., 2005). In 2019, the USPSTF concluded that providing or referring pregnant or postpartum women who are at increased risk to cognitive behavioral therapy (CBT) or interpersonal therapy (IPT) has a moderate net benefit in preventing perinatal depression. Hybrid effectiveness-intervention trials are needed to better understand how these interventions may be implemented at scale by trained providers with fidelity and effectiveness across diverse healthcare and community settings.

Priority research areas include: 1) understanding features of healthcare settings that may impede assessing risk and implementing effective interventions for perinatal depression at scale with fidelity and sustainability; 2) identifying women at increased risk of perinatal depression who are likely to benefit from preventive interventions; 3) optimizing evidence-based interventions so they can be implemented broadly and efficiently; 4) addressing logistical barriers that may interfere with engagement, participation, and adherence to interventions for perinatal depression; and, 5) incorporating technology to improve implementation of perinatal depression interventions; train local providers and monitor treatment fidelity over time; and assist the identification, engagement, and retention of suitable candidates for perinatal depression interventions.

The ultimate goal of this research is to contribute to an evidence base of effective perinatal prevention interventions that can be sustainably implemented in health care and community settings, including those that reach underserved populations and that have the potential to be administered at scale.