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

Abstract

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.

Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States

“…Several studies have supported the magnitude of the effects of PPD on women, especially among minority, low-income populations, and the potential for long-lasting effects on the infant (Kim et al, 2012). The consensus among researchers is that an increased level of social support is associated with less PPD (Brown et al, 2012;Chien et al, 2012;R.…”

“…8). 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, & ReyesRubilar, 2011).…”

Magnitude and risk factors for postpartum symptoms: A literature review

“…A striking prevalence of postpartum depression of 33% to almost 40% was observed among low-income mothers between three months and nine months after delivery (Gress-Smith et al, 2012;Ortiz Collado et al, 2014). However, the prevalence is low at 17.0% at seven days postpartum (Kim et al, 2012). Disaster is usually a cause of psychopathology.…”

Development and Evaluation of a Perinatal Service Delivery Web Platform for Prenatal Care Coordinators (Preprint)

“…Therefore, focus has been on developing systems that provide MHWs with automated diagnostics and guidance in routine actions of care [13,14,27]. Mobile apps that can aid MHWs in remotely obtaining results of ultrasound scans have been evaluated [2,17].…”