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Evaluation of a complex mental health promotion intervention: revealing and reinforcing health inequalities?. Heather Rowe PhD MAPHA Jane Fisher PhD MAPPS Key Centre for Women’s Health in Society Melbourne School of Population Health Faculty of Medicine Dentistry and Health Sciences
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Evaluation of a complex mental health promotion intervention:revealing and reinforcing health inequalities? Heather Rowe PhD MAPHA Jane Fisher PhD MAPPS Key Centre for Women’s Health in Society Melbourne School of Population Health Faculty of Medicine Dentistry and Health Sciences University of Melbourne Victoria AUSTRALIA
Acknowledgements • Funding • beyondblue the National Depression Initiative • Australian Government Department of Family Housing Community Services and Indigenous Affairs • Research Assistance • Lauren Matheson • Daria Bodzak • Karen Wynter • Nurse recruiters • Families who participated
PEPP a complex intervention • Question • Postpartum mental health • Psychosocial factors • Setting • Primary health care • Maternal and Child Health Nurses • Population • Universal • Mothers fathers and first newborns • Intervention • Preventative • Trained facilitators; group program
Innovative • Evidence based • Partner • renegotiating the household workload • Baby • dysregulated sleep • inconsolable crying • Non-psychiatric language • Established health promotion model • Timing and salience • Building local capacity • Mental health • Evidence for practice
Aims of PEPP To • Promote confidence • Reduce distress • Decrease incidence of postnatal depression
Evidence • RCT? • Diffusion of innovation • Contamination • Cluster RCT? • Evaluation design • CBA – controlled before-and-after design • 6 settings • 3 metropolitan • 3 rural • Maternal and Child Health Nurse recruiters • 3 trained PEPP facilitators
Trial design Time
Measures- men and women Computer assisted telephone interviews • Baseline • Sociodemographic; psychiatric history; current mood (Edinburgh scale); partner relationship; baby behaviours; standardised measures • Outcome • Primary • Diagnoses of common mental disorders: anxiety and depression (DSM IV) • Secondary • Partner relationship • Baby behaviour
Trial design Time
Conclusions • Model of evaluation • Strength of evidence • Quality of evidence • Model of health promotion • Reach of intervention • Innovative media