Multi-level Public Health Resilience Building Intervention
Building Maternal Resilience Through Mindfulness Mobile App
Postpartum depression is a critical public health issue that has been intensified in the past couple of years due to the COVID-19 pandemic, in the US, with 13% of women diagnosed within the first month of delivery and 19% within three months (Kornfield et al, 2021). There is significant evidence that stress during pregnancy increases the risk of postpartum depression, impairs mother-infant bonding, and has adverse effects on maternal health (Kornfield et al, 2021). According to a 2021 study, the pandemic was an acute environmental stressor that contributed to postpartum outcomes which gave rise to investigating prenatal risk and resilience risk factors. Researchers examined adverse childhood experiences, prenatal depression/anxiety, COVID-19 related distress and impaired maternal bonding (Kornfield et al, 2021). Results identified a unique predictor for impaired maternal-infant bonding was prenatal depression, while protective resilience factors included self-reliance, emotional regulation and non-hostile relationships. Evidence indicates multi-level public health interventions that build resilience through behavior and policy change can be effective in reducing this public health problem (Kornfield et al, 2021).
Background and Epidemiology of the Critical Public Health Issue of Perinatal Mental Health
PERINATAL MENTAL HEALTH
1 in 5 women experience a mental health complication in pregnancy or postpartum
Perinatal Mental Health concerns are the #1 health complication of pregnancy and birth
Common types of perinatal health concerns (% of women experience):
- Baby Blues (~80%)
- Depression/Anxiety (~10-25%)
- Panic (~15%)
- Posttraumatic Stress Disorder (~3-5%)
- Obsessive Compulsive Disorder (~3-5%)
- Postpartum Psychosis (~1-2 per 1,000 births) – call 911
(Florida Maternal Mental Health Collaborative (FMMHC), 2022)
RISK FACTORS
- Stressful life events
- Low social support
- Previous history of depression
- Family history of depression
- Difficulty getting pregnant
- Being a mom to multiples infants
- Being a teen mom
- Preterm birth (before 37 weeks)
- Pregnancy/birth complications
(Postpartum Support International (PPI), 2022)
POSTPARTUM DEPRESSION IS A CRITICAL PUBLIC HEALTH ISSUE IN THE US
- Can be identified as a Perinatal Mood & Anxiety Disorder (PMADS)
- Has intensified in the past couple of years due to the COVID-19 pandemic
- 13% of women diagnosed within the first month of delivery
- 19% within three months
SIGNIFICANT EVIDENCE THAT STRESS DURING PREGNANCY INCREASES
Risk of postpartum depression
Impairs mother-infant bonding
Has adverse effects on maternal health
GETTING HELP
- Screening by OB/GYN provider
Resources through organizations
- Postpartum Support International (PPI)
- Centers for Disease Control (CDC)
- Florida Maternal Mental Health Collaborative (FMMHC)
(CDC, 2022)(PPI, 2022)(FMMHC, 2022)
Priority population and rationale for geography
PROPOSED INTERVENTION HAS THE FOLLOWING TARGET CRITERIA
Pregnant and postpartum women
Screening positive for prenatal depression/anxiety
Lower Socioeconomic Status (SES)
Residing in Florida
Being referred to high risk OB/GYN care at University of Florida (UF) Shands Hospital or Health Clinics
PROPOSED THE INTERVENTION WILL ENROLL
Maximum of 500 pregnant women or postpartum women (within the first year of delivery)
Meet the target audience criteria
Receiving care from a large integrated health care system, University of Florida (UF) Health)
Willing to be part of Intervention Timeframe: August 2022 through July 2023
Have a smartphone & willing to use a mindfulness app for 10-20 min day for up to 1 year
Marketing/Theme Products and Recruitment
Intervention Poster & Radio Ad Attached
CDC Social Ecological Levels
PowerPoint Presentation Attached
References
Avalos, Aghaee, S., Kurtovich, E., Quesenberry, C., Nkemere, L., McGinnis, M. K., & Kubo, A. (2020). A mobile health mindfulness intervention for women with moderate to moderately severe postpartum depressive symptoms: Feasibility study. JMIR Mental Health, 7(11), e17405–e17405. https://doi.org/10.2196/17405
Centers for Disease Control and Prevention (CDC). (2022, June 10). Depression Among Women: A framework for prevention. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/reproducti.../index.htm#Treatment
Dixon, B. (2022, June 9). Assignment: Multi-Level Public Health Resilience-Building Intervention: Sample Theme and Marketing Products. eLearning - University of Florida. Retrieved from https://ufl.instructure.com/co.../assignments/5205319
Florida Maternal Mental Health Collaborative. (2022, June 15). Get the facts. Retrieved from: https://www.flmomsmatter.org/pmad-facts
Headspace. (2022, June 15). Science at Headspace. Retrieved from https://www.headspace.com/science
Kornfield, S.L., White, L.K., Waller, R., Njoroge, W., Barzilay, R., Chaiyachati, B.H., Himes, M.M., Rodriguez, Y., Riis, V, Simonette, K, Elovitz, M.A., and Gur, R.E. (2021). Risk And Resilience Factors Influencing Postpartum Depression and Mother-Infant Bonding During COVID-19. Health Affairs (Millwood, Va.), 40(10), 1566–10. https://doi.org/10.1377/hlthaff.2021.00803
Postpartum Support International. (2022, June 15). Get help. Retrieved from: https://www.postpartum.net/get-help/
Roberson, Roussos-Ross, D., & Goodin, A. J. (2020). Impact of an on-site perinatal mood disorders clinic in the diagnosis and management of perinatal mood disorders. Journal of Perinatal Medicine, 48(8), 837–843. https://doi.org/10.1515/jpm-2020-0036
The American College of Obstetricians and Gynecologists. (2022, June 15). Postpartum Depression. Retrieved from: https://www.acog.org/womens-he...amp;utm_campaign=otn
University of Florida (UF) Health. (2022, July 31). Statewide Impact and the Future. https://destination.ufhealth.o...pact-and-the-future/
University of Florida (UF), Shands Hospital. (2022, May 27). UF Women’s Health Center: Pregnancy Center. Retrieved from: https://ufhealth.org/uf-health...nter/womens-services
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