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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. Community Partnerships

Approach. Collaborate with WIC clinics to address postpartum depression and anxiety screening.

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Overview. Collaboration with partners within the community such as WIC clinics has been shown to be an effective intervention for increasing access to postpartum depression and anxiety screening tools.[1] The WIC intake consultation for expecting and newly postpartum women offers a prime opportunity to conduct standardized screening tools in order to identify individuals experiencing postpartum depression and anxiety symptoms. Community partnership interventions can also include the use of community health workers (CHWs) who are trained to assist providers with postpartum depression and anxiety screening and referrals by addressing patient barriers to care.[2] Evidence has found that Community partnerships including collaboration with WIC clinics, the use of CHWs and case management have the potential to increase postpartum depression and anxiety screening rates.[1,2,3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some 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.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

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. Screening (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 WIC staff trained on postpartum mental health, screening protocols, and referral process. (Assesses the capacity building efforts within partner organizations)
  • Number of outreach events or activities conducted in collaboration with WIC clinics to raise awareness about postpartum mental health and screening services. (Shows the joint efforts to engage and educate the community)

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

PROCESS MEASURES:

  • Percent of postpartum depression and anxiety screening protocols implemented at WIC clinics that align with evidence-based practices and guidelines. (Assesses the quality and rigor of the screening practices adopted through the partnership)
  • Percent of outreach and educational materials disseminated through the WIC partnership. (Measures the responsiveness of the joint community engagement efforts)

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

PROCESS MEASURES:

  • Number of cross-training sessions or learning collaboratives conducted between WIC clinics and mental health providers to enhance care coordination for postpartum women who report high levels of collaboration. (Measures efforts to strengthen integrated, cross-sector service delivery)
  • Number of postpartum women served by WIC clinics who report increased awareness, knowledge, and self-efficacy in managing their mental health as a result of the partnership's screening and education efforts. (Measures the impact on women's support and activation)

OUTCOME MEASURES:

  • Number of WIC clinics that demonstrate sustained improvements in postpartum depression and anxiety screening rates and referral outcomes over time. (Assesses the long-term impact and sustainability of the partnership's efforts)
  • Number improvement in population-level maternal mental health outcomes in communities served by the WIC partnership's screening and referral efforts. (Measures the long-term, transformative impact of the partnership on maternal health outcomes)

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

PROCESS MEASURES:

  • Percent of cross-training sessions or learning collaboratives conducted between WIC clinics and mental health providers to enhance care coordination for postpartum women who report high levels of collaboration. (Measures efforts to strengthen integrated, cross-sector service delivery)
  • Percent of postpartum women served by WIC clinics who report increased awareness, knowledge, and self-efficacy in managing their mental health as a result of the partnership's screening and education efforts. (Measures the impact on women's support and activation)

OUTCOME MEASURES:

  • Percent of WIC clinics that demonstrate sustained improvements in postpartum depression and anxiety screening rates and referral outcomes over time. (Assesses the long-term impact and sustainability of the partnership's efforts)
  • Percent improvement in population-level maternal mental health outcomes in communities served by the WIC partnership's screening and referral efforts. (Measures the long-term, transformative impact of the partnership on maternal health outcomes)

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] Giron, K., Noe, S., Saiki, L., Kuchler, E., & Rao, S. (2021). Implementation of Postpartum Depression Screening for Women Participating in the WIC Program. Journal of the American Psychiatric Nurses Association, 27(6), 443-449.
[2] Robidoux, H., Williams, A., Cormack, C., & Johnson, E. (2023). Maternal Postpartum Depression Screening and Referral in a Latinx Immigrant Population: A Quality Improvement Study. Journal of Immigrant and Minority Health, 1-9.
[3] Coffman, M. J., Scott, V. C., Schuch, C., Mele, C., Mayfield, C., Balasubramanian, V., ... & Dulin, M. (2020). Postpartum depression screening and referrals in special supplemental nutrition program for women, infants, and children clinics. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(1), 27-40.

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.