Online Program

Evaluation of a Community-based Postpartum Depression Coalition Model Using a Multiple Streams Framework: Building the Evidence to Bring Policy to Practice

Tuesday, November 3, 2015 : 10:50 a.m. - 11:10 a.m.

Lynne Man, PhD, MS, MPH, Health Administration, Regis College, Weston, MA
Leslie A. Mandel, PhD, MA, MSM, School of Health Sciences, Regis College, Waltham, MA
Liz Friedman, MFA, MotherWoman, Amherst, MA
Annette Cycon, LICSW, MotherWoman, Inc., Amherst, MA
Background: Postpartum-depression affects 10–20% of all and 40–60% of low-income mothers. Sixteen states have passed/pending legislation for Postpartum-depression awareness, screening and/or treatment. These policies give communities resources to address Postpartum-depression. Limited understanding exists of how community coalitions facilitate policy implementation. The Community-based Perinatal Support Model (CPSM) is a multidisciplinary coalition approach to developing organizational policies and systems for those affected by Postpartum-depression.  This study evaluated the contribution of CPSM to the efficacy of networks established to screen and treat Postpartum-depression in four Western Massachusetts communities.

Methods: A qualitative multiple embedded case-study design using 'coalitions' as the unit of analysis. Variables included coalition structure; internal/external leadership; community champions; resources; and readiness. Findings and discussion of broader systematic CPSM adoption are presented using a Multiple Streams Framework.

Results: Barriers to Community-based Perinatal Support Model implementation include competing priorities; external leadership; local contextual issues; and lack of funding/organizational support or community readiness. Facilitators to implementation include leadership development, professional training, community resources, referral/triage systems and Postpartum-depression screening protocols/tools. Strong public support was demonstrated through champion involvement; committed internal/organizational support and leadership; diverse membership; clear vision/goals; systems approach adherence; and high-quality technical assistance. Passage of mandatory Postpartum-depression screening provided the impetus for converging 'streams' to develop sustainable, comprehensive systems-based approaches. 

Implications: . Understanding streams in context of community dynamics facilitates policy implementation; improves continuity, quality and broader service dissemination; and sustains the Postpartum-depression policy agenda. Capitalizing on a policy opportunity contributes to expanded state funding allocations for CPSM statewide replication

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain a “multiple streams” conceptual framework as an organizing principle in implementation of state- and institutional–level policies. Describe a rigorous process evaluation using qualitative methods applied to coalition framework. Identify and compare strategies and challenges to local and state policy implementation and sustainability of postpartum depression community coalitions

Keyword(s): Community-Based Partnership & Collaboration, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was co-principal on this evaluation. Leslie Mandel (other co-principal) and myself have applied several theoretical frameworks to the model under investigation in order to impact policy- and systems-level changes. The present study contributed to state funding to bring the model to scale, and is therefore of interest to others in the field. We have completed additional evaluations in which theory is used to expand applications of findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.