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Improving mental health in pregnancy for refugee women: protocol for the implementation and evaluation of a screening program in Melbourne, Australia

Boyle, Jacqueline Anne, Willey, Suzanne, Blackmore, Rebecca, East, Christine, McBride, Jacqueline, Gray, Kylie, Melvin, Glenn, Fradkin, Rebecca, Ball, Natahl, Highet, Nicole and Gibson-Helm, Melanie 2019, Improving mental health in pregnancy for refugee women: protocol for the implementation and evaluation of a screening program in Melbourne, Australia, Journal of Medical Internet Research, vol. 8, no. 8, pp. 1-11, doi: 10.2196/13271.

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Title Improving mental health in pregnancy for refugee women: protocol for the implementation and evaluation of a screening program in Melbourne, Australia
Author(s) Boyle, Jacqueline Anne
Willey, Suzanne
Blackmore, Rebecca
East, Christine
McBride, Jacqueline
Gray, Kylie
Melvin, GlennORCID iD for Melvin, Glenn orcid.org/0000-0002-6958-3908
Fradkin, Rebecca
Ball, Natahl
Highet, Nicole
Gibson-Helm, Melanie
Journal name Journal of Medical Internet Research
Volume number 8
Issue number 8
Article ID e13271
Start page 1
End page 11
Total pages 11
Publisher JMIR
Place of publication Toronto, Ont.
Publication date 2019-08
ISSN 1438-8871
Keyword(s) mass screening
mental health
pregnancy
prenatal care
refugees
transients and migrants
Summary Background: Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is the leading cause of maternal morbidity postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program's feasibility and acceptability to women and health care providers (HCPs). Objective: The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). Methods: This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program's ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program's acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. Results: The recruitment is complete, and data collection and analysis are underway. Conclusions: It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women.
Language eng
DOI 10.2196/13271
Indigenous content off
Field of Research 170199 Psychology not elsewhere classified
08 Information and Computing Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30129370

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.