Vanderkruik Rachel, Freeman Marlene P, Gaw Margaret, Reuman Audrey R L, Verghese Maya, Louis Courtney C, Jellinek Michael, Bartels Stephen, Cohen Lee S
Massachusetts General Hospital, Ammon-Pinizzotto Center for Women's Mental Health, Boston, Massachusetts, United States of America.
Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2025 Mar 21;20(3):e0319181. doi: 10.1371/journal.pone.0319181. eCollection 2025.
Perinatal depression (PND) is an underrecognized and underdiagnosed public health issue with long-term adverse impacts on birthing parents and their children. While obstetrics practices are increasingly encouraged to use existing evidence-based screening tools, there is little data describing the extent to which screening practices and subsequent referrals to care are implemented in clinical settings. The Screening and Treatment Enhancement for Perinatal Depression (STEPS for PPD) study aims to characterize PND screening and referral procedures and identify areas for system improvements. We describe a protocol for an observational study, guided by implementation science frameworks, examining the role of embedded perinatal social workers in managing PND across Mass General Brigham system obstetrics clinics. Our mixed-methods approach integrates qualitative and quantitative data from a variety of sources, including electronic health records, patient-reported surveys, and qualitative interviews, to capture complex screening and referral practices across a large academic medical system. We aim to characterize nuances within the screening and referral system and identify barriers and facilitators to care to inform future hybrid-implementation effectiveness research and improve patient outcomes.
围产期抑郁症（PND）是一个未得到充分认识和诊断的公共卫生问题，对产妇及其子女有长期的不利影响。虽然越来越鼓励产科医疗机构使用现有的循证筛查工具，但几乎没有数据描述在临床环境中筛查实践及后续转诊接受治疗的实施程度。围产期抑郁症筛查与治疗强化（STEPS for PPD）研究旨在描述PND筛查和转诊程序，并确定系统改进的领域。我们描述了一项观察性研究的方案，该研究以实施科学框架为指导，考察围产期社会工作者在麻省总医院布莱根医疗系统产科诊所管理PND方面的作用。我们的混合方法将来自各种来源的定性和定量数据相结合，包括电子健康记录、患者报告的调查和定性访谈，以了解大型学术医疗系统中复杂的筛查和转诊实践。我们旨在描述筛查和转诊系统中的细微差别，识别护理的障碍和促进因素，为未来的混合实施效果研究提供信息，并改善患者结局。
