Department of Psychiatry, Hennepin County Medical Center, Minneapolis, MN 55404, USA.
Matern Child Health J. 2012 May;16(4):921-8. doi: 10.1007/s10995-011-0817-6.
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.
本研究旨在测试使用交互式语音应答（IVR）电话系统筛查低收入、英语和西班牙语母语产后抑郁症的可行性。新分娩的母亲在医院接受采访。同意参与的受试者在医院填写背景问卷，并被要求在产后 7 天拨打自动电话系统，完成爱丁堡产后抑郁量表（EPDS）的 IVR 版本。在电话筛查过程中，根据抑郁评分，受试者被引导至不同的结束叙述，随后将评分结果发布到一个受密码保护的网站上。逻辑回归用于评估人口统计学和社会心理因素、IVR 参与度和抑郁评分之间的关系。在 838 名种族多样、收入低的产后母亲中，有 324 名（39%）拨打了自动电话筛查系统。那些打电话的人更有可能至少受过高中教育（OR=1.63，95%CI：1.23，2.16）、有工作（OR=1.48，95%CI：1.08，2.03）和家庭食物有保障（OR=1.50，95%CI：1.06，2.13）。在婚姻状况、种族/民族、产次或自我报告的抑郁病史方面，打电话者和不打电话者之间没有统计学上的显著差异。产后抑郁症症状的发生率为 17%（n=55），与单身（AOR=2.41，95%CI：1.29，4.50）、初产妇（AOR=2.43，95%CI：1.34，4.40）、临时住房（AOR=2.35，95%CI：1.30，4.26）、焦虑症病史（AOR=2.79，95%CI：1.69，6.67）和自伤史（AOR=2.66，95%CI：1.01，6.99）有关。在处于不利地位的母亲中，使用自动电话筛查产后抑郁症是可行的，但那些具有最高社会心理风险因素的母亲可能不会选择或无法获得这种筛查。IVR 可以用于补充基于办公室和家访的筛查方案，并向患者提供有关心理健康资源的教育。
