Recorded presentation

Emily Feinberg, ScD, CPNP and Jenifer Goldman-Fraser, PhD, MPH. Department of Maternal and Child Health, Boston University School of Public Health, Talbot Building - 5W, 715 Albany St, Boston, MA 02118, 617-414-3667, emily.feinberg@bmc.org

Depression in mothers of young children remains under-identified and under-treated despite elevated prevalence, known risk factors, and its impact on the maternal and child health. Pediatric well-child visits offer an alternative setting for the identification and management of maternal depression. The presentation will describe an innovative demonstration project that uses the technology embedded in the electronic medical record (EMR) to screen for maternal depression at pediatric well-child visits. The electronic form will include a structured, standardized, and validated depression screening tool, the PHQ 9, which has been used widely in primary care settings. The electronic form will score the screening measure, offer decision support regarding the interpretation of score, suggest management options appropriate to pediatric settings, and link to culturally appropriate educational handouts. We will use data abstracted from the EMR to assess the number of eligible women screened, the proportion of positive screens, and women’s preferences for further management, which will include referral to behavioral health services, closer follow-up within the pediatric practice, referral to the woman’s primary care provider, and social service support. The presentation will focus on design and implementation issues including decision-making regarding the selection and adaptation of the screening tool, development of pediatric-appropriate management options, and issues related to provider training and receptivity. The project, which is being conducted in community health centers with a multi-ethnic low-income population, is in the implementation phase. It offers a model to address a significant clinical issue that impacts the well-being of women and children.

Learning Objectives:

• Articulate the rationale for using pediatric settings to detect and manage maternal depression.
• Describe the use of the technology embedded in electronic medical records to guide the detection and management of maternal depression.
• List 3 barriers to screening for maternal depression and describe how the approach presented in the session addresses these barriers.

Keywords: Screening, Depression

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation