The primary goal of this proposal is to develop, implement, and evaluate an online module to improve obstetric providers? knowledge, attitudes, and practices regarding perinatal mood and anxiety disorders. Upwards of 1 in 5 women suffer from perinatal mood and anxiety disorders. Left untreated, they have deleterious effects on maternal and birth outcomes, infant attachment, and children?s behavior/development. While most obstetric providers report wanting to address perinatal mood and anxiety disorders, fear of liability, discomfort, and lack of knowledge and resources present barriers. To address this, our team developed the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms. MCPAP for Moms provides training for obstetric providers on how to detect, assess, and treat perinatal mood and anxiety disorders. While our training has been identified as a model for other states, it was developed specific to the Massachusetts environment and available mental health resources and is currently delivered in person. To begin to address this, in our Phase I project, we developed a prototype online training product, consisting of one module, entitled Basics of Addressing Perinatal Depression. Phase I participants? pre/post-test knowledge scores, applied knowledge change scores, and positive attitudes regarding depression and depression care increased significantly. Satisfaction with the course content, manner, and form of online presentation was also high. However, as Phase I was a prototype focused only on depression, learners asked for more content on differential diagnosis, patient engagement, treatment follow-up, and monitoring. Thus, we propose to build on Phase I with a Phase II project to develop a more comprehensive training entitled, Addressing Perinatal Mood and Anxiety Disorders. While Phase I was purposefully narrow and covered only depression and how to screen for it and start treatment, Phase II will focus more broadly on perinatal mood and anxiety disorders and cover how to differentiate depression from other psychiatric illnesses, follow-up after treatment initiation, and monitor patients? symptoms and adjust treatment as needed to achieve illness remission. We will conduct a formative evaluation of the 4-module training course via testing with 10 obstetric providers and obtain feedback from 5 women with lived experience of perinatal mood and anxiety disorders, and revise/refine based on these. We will test the effectiveness of all 4 modules by conducting a randomized controlled trial with 60 obstetric providers randomly assigned to the training (coursework group) (N=30) or an attention / wait-list control group (N=30). We will evaluate providers?: (1) knowledge acquisition (pre/post-test comparison); (2) change in provider attitudes (beliefs, self-efficacy, and confidence) toward perinatal depression and anxiety care (pre/post comparison), and (3) satisfaction with course content and usability (post). We will then revise the modules, producing a final product for Phase III commercialization. If effective, our training will help obstetric providers implement screening for perinatal mood and anxiety disorders and respond appropriately, thus getting women needed care.
We will leverage existing roles and resources in Ob/Gyn settings to provide a solution to a critical public health issue ? perinatal mood and anxiety disorders. Our proposed training, Addressing Perinatal Mood and Anxiety Disorders, has the potential to address a training gap and increase obstetric provider capacity to detect, assess, and treat perinatal mood and anxiety disorders, which is an essential part of the system change needed to positively impact the health and wellness of many mothers, families, and babies.
