Conference Abstract Compendium Examples from the ... - CityMatCH

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2009 CityMatCH Urban MCH Leadership ConferenceImplementing perinatal depression screening in a Medicaid-based programPRIMARY CONTACT:Paula S. Binner, MSW, LCSWClinical Social Work ConsultantLos Angeles County Department ofPublic Health/MCAH600 S. Commonwealth Ave, 800Los Angeles, CA, 90005Phone: (213) 639-6424Fax: (213) 639-1034Email: pbinner@ph.lacounty.govWebsite:www.publichealth.lacounty.gov/mchCATEGORYPreconception health and health careMental healthFOCUSProgram Policy FocusCO-PRESENTER(S)/AUTHOR(S):Joanne Roberts, jroberts@ph.lacounty.gov(Author, Presenter)Diana Ramos, dramos@ph.lacounty.gov(Author)Cynthia Harding, charding@ph.lacounty.gov(Author)ISSUEDepression is one of the most common complications during and after pregnancy. It disproportionatelyaffects minority women. Untreated depression during pregnancy is associated with preterm delivery,neonatal growth retardation, maternal complications, and is an important predictor of postpartumdepression.The Comprehensive Perinatal Services Program (CPSP) is an enhanced program for Medi-Cal (Medicaid)eligible pregnant women. Los Angeles County CPSP provides support and oversight to approximately450 state-certified CPSP providers. Besides obstetrical care, CPSP includes a comprehensive assessmentof health education, nutrition, and psychosocial variables affecting pregnancy that is completed eachtrimester and postpartum. The current CPSP assessment tool does not specifically address depression.According to the 2005 Los Angeles Mommy and Baby (LAMB) Survey, the prevalence of depressionduring pregnancy was 12-37%.Our project aims to increase education and screening for perinatal depression among Los Angeles CPSPproviders.SETTINGThe intervention sites are Los Angeles CPSP providers in two pilot areas, one of which has the highestincidence of depression based on the LAMB Survey. CPSP clinics in other areas that request training willalso be included.16
2009 CityMatCH Urban MCH Leadership ConferencePROJECTA baseline survey of at least 20% of CPSP providers will be conducted to assess the extent and frequencyof depression screening. A pilot group of providers and staff will receive depression education andscreening training at their clinic sites. Routine screening for all prenatal patients at least once eachtrimester and postpartum will be promoted in accordance with the American College of Obstetricians andGynecologists guidelines. Follow-up questionnaires at three months and six months will be sent toparticipants to assess incorporation of training recommendations. In addition, patients who receiveddepression screening will be asked to provide feedback. These results will be used to provide feedback toproviders and refine provider trainings.ACCOMPLISHMENTS/RESULTS• Providers’ knowledge of perinatal depression screening, treatment, and resources will increase.• Depression screening in the pilot areas will increase by at least 50% compared to baseline.• Perinatal depression trainings will be offered to all County CPSP providers at their clinic sites. Followupinformation will be provided through posting of a Perinatal Depression Toolkit on the LA CountyCPSP website.BARRIERS• Clinician reimbursement – screening and referral time reimbursable through CPSP.• Lack of mental health providers for diagnosis and treatment – identify local referral resources.• Stigma associated with depression – patient education needed.LESSONS LEARNED• Providers are more likely to screen for depression during pregnancy when given appropriate tools andtraining.• Depression screening can be incorporated into the CPSP psychosocial component, thereby reducingcomplications associated with perinatal depression.17
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