Screening for Postpartum Depression Among Low-Income Mothers Using an Interactive Voice Response System

Department of Psychiatry, Hennepin County Medical Center, Minneapolis, MN 55404, USA.
Maternal and Child Health Journal (Impact Factor: 2.24). 05/2011; 16(4):921-8. DOI: 10.1007/s10995-011-0817-6
Source: PubMed


This study tested the feasibility of using an interactive voice response (IVR) phone system to screen for postpartum depression among low-income, English- and Spanish-speaking mothers. Newly delivered mothers were interviewed in the hospital. Consenting subjects completed a background questionnaire and were asked to call an automated phone system 7 days postpartum to complete an IVR version of the Edinburgh Postnatal Depression Screen (EPDS). During the phone screen, subjects were branched to different closing narratives based on their depression scores which were later posted to a password protected website. Logistic regression was used to assess relationships between demographic and psychosocial factors, IVR participation, and depression scores. Among 838 ethnically diverse, low income, postpartum mothers, 324 (39%) called into the automated phone screening system. Those who called were more likely to have at least a high school education (OR = 1.63, 95%CI: 1.23, 2.16), be employed (OR = 1.48, 95%CI: 1.08, 2.03) and have food secure households (OR = 1.50, 95%CI: 1.06, 2.13). There was no statistically significant difference between callers and non-callers in terms of marital status, race/ethnicity, parity, or self-reported history of depression. Postpartum depression symptoms were present in 17% (n = 55) and were associated with being single (AOR = 2.41, 95% CI: 1.29, 4.50), first time mother status (AOR = 2.43, 95% CI: 1.34, 4.40), temporary housing (AOR = 2.35, 95% CI: 1.30, 4.26), history of anxiety (AOR = 2.79, 95% CI: 1.69, 6.67), and history of self-harm (AOR = 2.66, 95% C: 1.01, 6.99). Automated phone screening for postpartum depression is feasible among disadvantaged mothers but those with the highest psychosocial risk factors may not choose or be able to access it. IVR could be used to supplement office- and home visit-based screening protocols and to educate patients about mental health resources.

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Available from: Joni Geppert, Jan 21, 2015
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    • "). Support is paramount, and early recognition and treatment of PPD among disadvantaged populations in particular is an urgent health issue (Kim et al., 2012). Many studies have found that increased levels of support were associated with lower PPD scores (Brown, Harris, Woods, Burman, & Cox, 2012; Chien, Tai, & Yeh, 2012; R. C. Edwards et al., 2012; Fowles et al., 2012; Quelopana, Champion, & Reyes- Rubilar, 2011). "
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    ABSTRACT: Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought professional help. The results revealed that screening for depression alone may not be sufficient, that mothers are willing to contact a professional for help in the postpartum period, and that assessments after birth should include a broader assessment of life’s difficulties rather than focusing on childcare responsibilities alone.
    Full-text · Article · Jan 2015 · Journal of Perinatal Education
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    • "Preventive care is another health care domain in which IVR systems have been shown to be effective in increasing health behaviors. Several studies have shown the utility and feasibility of IVR systems in increasing the frequency of preventive care behaviors such as screening for cervical cancer, breast cancer, immunization for influenza in target populations, screening for postpartum depression, and adherence to hospital appointments (Corkrey, Parkinson, & Bates, 2005; Corkrey, Parkinson, Bates, Green, & Htun, 2005; Crawford et al., 2005; Fiscella et al., 2011; Hasvold & Wootton, 2011; Kim et al., 2012). A number of screening measures have been adapted for IVR administration, such as screening for depression (Kim, Bracha, & Tipnis, 2007; Moore et al., 2006; Mundt, Geralts, & Moore, 2006; Rush et al., 2006), alcohol use (Mundt, Bohn, King, & Hartley, 2002), binge eating (Bardone, Krahn, Goodman, & Searles, 2000), and sexual activity (Schroder, Johnson, & Wiebe, 2007). "
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    ABSTRACT: Objectives: Interactive voice response (IVR) systems are computer programs that can interact with people to provide a number of services from business to health care. However, surveys examining people's attitudes toward these systems have consistently found that people in general and older people in particular strongly dislike these systems. We wanted to determine the memory and cognitive abilities that predict successful IVR interactions for older people. Method: We compared the performance of 185 older adults (aged 65 and older) on normed cognitive tests (the Wechsler Adult Intelligence Scale fourth edition and the Wechsler Memory Scale fourth edition) with their performance on 4 real-life IVR systems that included fact-finding at governmental agencies and plane ticket reservation. Results: The results indicated that adults aged 65 and older experience significant difficulties in interacting with IVR systems. A significant number of people (20.5%) could not complete any of the tasks. Participants who could not complete any task were older and had the lowest full-scale IQ. However, there was little difference between the age of participants who completed 1, 2, 3, or 4 tasks. Rather, auditory memory and working memory were the best overall predictors for success in IVR tasks. Discussion: The impact of poorer auditory memory and working memory is compounded by programming practices that increase the demand on these abilities and create unnecessary difficulties. Successful use of IVR systems could eventually complement in person health services.
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    ABSTRACT: In this work the development and use of mobile applications for pregnant women is investigated. The state of the art reveals the need of developing an app for mobile devices, as a service to prevent depression in pregnant women through the assessment of the emotional state, early detection of anxiety or depression symptoms and rapid referral for psychological care to prevent suffering and chronicity of symptoms. This app could be used even in regions where the health assistance is poor, like in rural areas.
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