Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106893

Emily Feinberg, Sc D¹, Jenifer Goldman Fraser, PhD, MPH¹, Lorenza Holt¹, Kyung Rhee, MD², Gabriele Harrison, BSN³, and Melanie Smith, MPA¹. (1) Department of Maternal and Child Health, Boston University School of Public Health, Talbot Building - 5W, 715 Albany St, Boston, MA 02118, 617 414-1468, jgfraser@bu.edu, (2) Pediatrics, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, (3) Department of Parent Child Nursing, Simmons School of Health Studies, 300 The Fenway, Boston, MA 02115

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, particularly for women who do not have a primary care provider. The presentation will describe preliminary findings of a project that aims to develop an evidenced-base approach to maternal depression screening in pediatric settings. The project is being conducted in 3 health centers with multi-ethnic, low-income women. Phase 1 of the project has focused on gathering qualitative data to understand barriers to implementation. We have conducted 6 focus groups of mothers whose children receive care at the sites, 18 interviews health care providers, and 10 interviews with community-based professionals. Specific barriers differed for mothers and health care providers. Pediatric providers focused on the contradiction that mothers who were screened at their child's visit were not their patients. Documenting information related to the mother's emotional health in the child's chart raised concerns about confidentiality. Management required coordination with adult services that were unfamiliar to pediatricians. Maternal concerns focused on potential child protective services involvement should she disclose depressive symptoms to her child's doctor. To address identified concerns we have developed trainings for pediatric providers and a standardized detection and management protocol. We will evaluate data from this protocol to assess the number of eligible women screened, the proportion of positive screens, women's preferences for further management, and women's engagement in care.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the opportunities and challenges to adressing maternal depression in pediatric settings
• Identify the concerns of low-income, ethnically diverse mothers regarding addressing emotional health concerns with pediatric providers
• Articulate an evidenced base approach to depression detection and management in pediatric settings

Keywords: Depression, Minority Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.