Ethnically diverse mothers' views on the acceptability of screening for depressive symptoms during pediatric well-child visits

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 of maternal depressive symptoms. However, there is limited knowledge about the acceptability of depression screening in pediatric settings, particularly among ethnically diverse populations. We conducted in-depth interviews with 42 women whose children, 6 months to 4 years, received care at community health centers that had implemented screening for depressive symptoms in pediatric visits. The sample was 12% white, 26% Black, 36% Southeast Asian, 17% Hispanic, and 9% multiracial. Interviews were analyzed by three research assistants, who developed codes to reflect key themes and concepts. We found that depression screening in the pediatric setting was acceptable to urban, ethnically diverse mothers. Mothers considered their child's pediatric provider to be an appropriate person with whom to discuss their emotional health, often based on the stability of the relationship and their experience of receiving helpful referrals to community-based services, such as food programs, that might be considered beyond the confines of traditional pediatric care. Mothers were keenly aware of the impact of their mood on their child's behavior. Consequently, they felt that addressing their concerns was an important component of pediatric healthcare. Stigma and fear of child protective services were widespread but mothers articulated clear strategies that could alleviate their concerns. Findings from this study should decrease barriers to expanding screening for maternal depressive symptoms to pediatric settings.