Happy Moms, Happy Babies An Online Resource Center for Postpartum Depression

1. Happy Moms, Happy BabiesAn Online Resource Center for Postpartum Depression HLTH670  Spring 2010  Toni Aluko Chandria Jones  Sarah Lerner  Kate Zebrak May 18, 2010

2. Problem Statement What is occurring? • Postpartum Depression (PPD) affects 13% of women during the first year after childbirth • Feelings of guilt or shame about these emotions • Unaware they have PPD or are unaware there is help • Often goes undetected/untreated by mom, family, doctor What could occur if  there is not communication about PPD? Mothers • Delay in treatment, worsening symptoms Infants • Conduct or attention disorders, developmental delays, poor attachment Families • Depression in fathers, strained relationships

3. Problem Statement: What Should Be Occurring New and Expecting Moms should: • Have tools to identify PPD • Speak comfortably with Health Care Providers (HCPS) about treatment options Health Care Providers should: • Screen expecting and new moms for PPD  • Communicate about PPD in ways that foster understanding and promote informed decision making Families and friends should • Have tools to recognize the signs of PPD • Communicate this to the women in a supportive way • Know how to support her in treatment and recovery

4. Communication Objectives For New or Expecting Mothers • Increase the number of new and expecting mothers who are aware of the signs, symptoms, and myths about PPD • Increase the number of new and expecting mothers who know that talking to their HCP about PPD improves their chances of getting necessary treatment For Healthcare Providers • Increase the number of HCP who know that talking about PPD with pregnant an new mothers, and using patient centered treatment can result in better outcomes for the mothers • Increase by the number of HCP who report communicating with and screening new and expecting moms for PPD, and then designing patient centered treatment Friends and Families • Increase by the number of family and friends who are aware of the signs and symptoms of PPD and ways to give and receive support • Increase the number of family and friends who know that recognizing PPD, supporting women with PPD, and taking care of themselves will lead to better outcomes

5. Website Objectives For New or Expecting Mothers • New Mothers will be able to access self screening tools, and information on PPD and how to talk to HCP, and tips, and share with other mothers online For Healthcare • HCP will be able to access screening tools, communication tips, and links to resources, and fact sheets for their patients For Friends and Families • Family will be able to access information on PPD, on how to support a mother with PPD, and how to take care of themselves and the rest of the family

6. Target Audience-PrimaryWomen who are pregnant or who have given birth within the past year Rationale • Prevalence of PPD is 10-20% in the first 6 months after giving birth • Multiple risk factors for PPD • PPD is a serious illness with multiple consequences • Women may not know enough about PPD to report symptoms of their physicians • Women may be reluctant to talk to their providers about PPD and seek help

7. Target Audience-SecondaryHealth Care Providers Rationale • PPD is under-diagnosed and undertreated •  Screening practice among HCPs is not universal •  Without screening with validated tools, up to 50% of cases of PPD can be missed by physicians  • Without treatment more than 50% of women may experience symptoms one year later  • Early detection and treatment that focuses on patient involvement in decision making can produce better treatment adherence, satisfaction, and outcomes

8. Target Audience-SecondaryFriends and Family of Women with PPD Rationale • Family and social support is very important in treatment of PPD • PPD affects not only women but the entire family and family dynamics • Partners of women with PPD may be more prone to developing depressive symptoms • Children may experience social and cognitive delays, and conduct and attention disorders • It is important for partners and other family members to know how to give support and seek support for themselves

9. Theory: Health Belief Model • Used to guide development of strategies, messages, and content for women • Perceived susceptibility - belief about one's chances of getting the condition • Perceived severity - belief about the seriousness of the condition and ensuing consequences/sequelae • Perceived benefits - belief that the recommended action is/will be efficacious in reducing seriousness or impact of the condition • Perceived barriers - perceptions of tangible (material) and psychological costs of taking advised action • Cues to action - strategies to activate readiness of individuals to change

10. Theory: Principles of Patient-Provider Communication • Used to guide development of strategies, messages, and content for PCPs Mutuality • Balanced relationship where patient and provider have equal involvement in treatment • Promotes patient-centered participatory approaches and shared decision making in treatment Concept of Active Listening • Paying attention and considering all points of view • Repeating what is heard to ensure understanding

11. Theory: Principles of Social Support • Used to guide development of strategies, messages, and content for family members and friends • Emotional support - expressions of empathy, love, trust, and caring (high level most consistently and strongly associated with good health and well-being) • Instrumental support - services, aid (tangible, hands-on) (low levels associated with high levels of depression) • Informational support - information, advice, suggestions • Appraisal support - information that may be used for self-evaluation (constructive criticism)

12. Strategies and Channels • Strategy: Create a public health education campaign • Tactics: develop materials for each of the target audiences • Posters, fact sheets, tips sheets, public service announcement, and website • Channels • Interpersonal channels (e.g., physicians, friends, family members) • Organizations and community groups • Potential Partners: WIC, American Pregnancy Association, National Alliance of Mental Illness, American Academy of Family Physicians, Planned Parenthood of America

13. Formative Evaluation (Pretesting) Steps in Developing and Pretesting Messages and Materials: • Review existing materials • Develop message concepts • Decide what materials to develop • Develop messages and materials • Pretest messages and materials Questions were asked about: • Concepts • Key messages • Satisfaction with products • Website usability

14. Findings of Pretesting Key Message •Take care of yourself to take care of your baby Website Name •Happy Moms, Happy Babies Logo

15. Final Materials

16. Demonstration of Website Let’s Take a Look!

17. Lessons Learned and Recommendations • Importance of research • Best practices • Pre-existing materials • Avoid re-inventing the wheel • Objectives and Theories • Pretesting is an essential part of the product development process • Can be fun!

18. We’re all in this together!Roles played by each group member • Chandria • Created Brochures, Posters, and Dialogue Cards for target audiences • Formulated Formative Evaluation and Website Usability forms • Edited and revised documents according to feedback • Conducted usability testing • Kate • Researched relevant health and communication theories • Compiled resources for website and WIKI • Drafted HCP and friends and family content for the website • Created and revised HCP fact sheets • Revised and edited problem statement and objectives according to feedback/comments

19. We’re all in this together!Roles played by each group member • Sarah • Organized PPD WIKI and Google Docs • Researched content and resources for website and WIKI • Drafted content for WIKI and website • Conducted product and usability testing • Created fact sheets for women and friends and families • Toni • Drafted content for WIKI and website • Created “Healthy Moms, Healthy Babies” website and Materials Website • Created PPD PSA video • Conducted product and usability testing

20. THANK YOU!!HAVE A GREAT SUMMER!! THANK YOU! HAVE A GREAT SUMMER!!