Clinician Management of Prenatal Depression Improved With Online Intervention

The likelihood of clinicians, nurses, mental health specialists, and public health educators screening, treating, and/or referring patients at risk for prenatal depression for follow-up care may be improved with brief online training, according to study findings published in Women’s Health Issues.

Researchers conducted a randomized controlled trial in which 162 clinicians (ie, nurses, mental health specialists, and public health educators) were randomly assigned into intervention (online training, n=56) or waitlist control groups (n=106). Participants who provided care to pregnant patients (ie, obstetricians, family medicine practitioners, nurses, nurse-midwives, nurse practitioners, psychiatrists, social workers, counselors, and public health educators) were actively recruited from Virginia and Colorado with the aid of state and local health departments and agencies.

Guidelines and evidence-based practices related to management of prenatal depression were covered in the online training. The Management of Maternal Depression Inventory was used to evaluate changes in clinicians’ attitudes, knowledge, and self-reported practices at baseline (T1), 6 weeks following baseline (T2), and 6 weeks after T2 (T3) in both arms.

Researchers observed 108 participants (intervention, n=41; control, n=67) completed data collection at all 3 time points. Participants (93.5% women, 88.9% White, 93.5% non-Hispanic) were primarily direct care practitioners (registered nurses, 39.8%; nurse-midwives, 11.1%), of whom 90% reported more than 2 years’ experience.

Regarding satisfaction working with mental health services, they found Time × Group relative improvements for the intervention group F(1,97) value (ratio of 2 variances) =10.89; (P =.001). With respect to increased self-reported screening, counseling, and referral for prenatal depression they noted F(1,97) =6.25; (P =.014).

For self-efficacy, there was a nonsignificant relationship over time, F(1,99) =2.48; (P =.13). For clinicians’ sense of responsibility, the researchers also found a nonsignificant relationship over time. Clinicians’ perceptions of patient barriers were found to be without a significant relationship over time.

Retention was shown to be moderate (control posttest-1, 78% retention; posttest-2, 61% retention; intervention posttest-1, 90% retention; posttest-2, 73% retention).

Limitations of the study include an underpowered homogenous sample, lack of retention, nonresponse bias, and self-reported measures leading to the possibility of response.

Study authors conclude, “Findings suggest this brief online training may enhance the likelihood of providers screening, treating, and/or referring patients for follow-up care for prenatal depression.”