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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Postpartum Mental Health Screening.

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Strategy. Provider Training

Approach. Educate providers at FQHCs on the use of a standardized screening tool to identify women with postpartum depression and anxiety.

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Overview. Provider training interventions such as slide presentations, educational sessions, video training, and other training modalities seek to improve the knowledge and skills of providers around the signs, symptoms, screening protocols and treatment options for postpartum depression and anxiety.[1,2,3] Research supports that increasing provider knowledge and comfort level around postpartum depression and anxiety screening improves screening and referral rates.[3] Findings also indicate that trainings that address the values of providers’ clients have a positive impact on health outcomes.[2]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Mental Health. This strategy promotes emotional, psychological, and social well-being of individuals and communities.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of FQHC providers who participate in training sessions on postpartum depression and anxiety screening using a standardized tool. (Measures the reach of provider education efforts)
  • Number of FQHCs that establish policies or protocols for routine postpartum mental health screening using a standardized tool. (Shows the translation of provider training into organizational practice changes)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of FQHC providers who participate in training sessions on postpartum depression and anxiety screening using a standardized tool. (Measures the reach of provider education efforts)
  • Percent of FQHCs that establish policies or protocols for routine postpartum mental health screening using a standardized tool. (Shows the translation of provider training into organizational practice changes)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of partnerships led by Title V established between FQHCs and community-based mental health providers to support referrals and care coordination for women with positive postpartum depression and anxiety screens. (Measures efforts to strengthen the continuum of care for postpartum mental health)
  • Number of FQHC quality improvement initiatives that include standardized postpartum mental health screening as a key performance metric. (Assesses the integration of screening into organizational quality assurance and improvement process)

OUTCOME MEASURES:

  • Number of postpartum women who receive timely and appropriate mental health interventions as a result of standardized screening and referrals by trained FQHC providers. (Measures the impact of the strategy on increasing access to effective treatment)
  • Number of FQHC-led community partnerships or coalitions that successfully promote policies and resources to support widespread adoption of standardized postpartum mental health screening. (Measures the strategy's influence on creating an enabling environment for system wide change)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of partnerships led by Title V established between FQHCs and community-based mental health providers to support referrals and care coordination for women with positive postpartum depression and anxiety screens. (Measures efforts to strengthen the continuum of care for postpartum mental health)
  • Percent of FQHC quality improvement initiatives that include standardized postpartum mental health screening as a key performance metric. (Assesses the integration of screening into organizational quality assurance and improvement process)

OUTCOME MEASURES:

  • Percent of postpartum women who receive timely and appropriate mental health interventions as a result of standardized screening and referrals by trained FQHC providers. (Measures the impact of the strategy on increasing access to effective treatment)
  • Percent of FQHC-led community partnerships or coalitions that successfully promote policies and resources to support widespread adoption of standardized postpartum mental health screening. (Measures the strategy's influence on creating an enabling environment for system wide change)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Beasley, D. R. (2021). An online educational intervention to influence medical and nurse practitioner students’ knowledge, self-efficacy, and motivation for antepartum depression screening and education. Nursing for Women's Health, 25(1), 43-53.
[2] Skoog, M., Rubertsson, C., & Kristensson Hallström, I. (2023). Feasibility of an evidence‐based educational intervention in screening immigrant mothers for postpartum depression: A pretest‐posttest experimental design. Scandinavian Journal of Caring Sciences, 37(1), 173-184.
[3] Accortt, E. E., Haque, L., Bamgbose, O., Buttle, R., & Kilpatrick, S. (2022). Implementing an inpatient postpartum depression screening, education, and referral program: a quality improvement initiative. American journal of obstetrics & gynecology MFM, 4(3), 100581.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.