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Factors affecting implementation of perinatal mental health screening in women of refugee background

journal contribution
posted on 23.03.2022, 03:16 by N Nithianandan, Melanie Gibson-HelmMelanie Gibson-Helm, J McBride, A Binny, KM Gray, C East, JA Boyle
Background: For women of refugee background, the increased risk of mental illness associated with pregnancy is compounded by pre- and post-settlement stressors. In Australia, antenatal screening for depression and anxiety symptoms using the Edinburgh Postnatal Depression Scale is recommended for all women. Despite this, screening is not routinely implemented and little is known about barriers and enablers to implementation for women of refugee background. Methods: Semi-structured interviews were conducted with a range of health professionals (n = 28: midwives, obstetricians, perinatal mental health and refugee health experts, interpreters) and women of refugee background (n = 9). Themes generated from thematic analysis were examined in relation to the Theoretical Domains Framework and Cultural Competence Conceptual Framework, followed by identification of effective behaviour change techniques to address the barriers and enablers identified by participants. These techniques formed the basis of recommendations to inform sustainable implementation of screening and referral. Results: Almost all participants perceived perinatal mental health screening to be necessary and most recognised the importance of post-traumatic stress disorder (PTSD) screening. Barriers and enablers were identified and related to eight domains: knowledge, skills, professional roles, beliefs about capabilities and consequences, environmental context, social influences and behavioural regulation. Conclusions: This research clarifies how mental health screening may be integrated into routine antenatal care for women of refugee background, in order to improve provision of recommended care. These theory-informed recommendations include an inter-disciplinary approach, coordinating care within and across services, addition of PTSD screening, and effective communication with women.

Funding

Improving pregnancy care for populations at risk in Australia | Funder: National Health and Medical Research Council | Grant ID: 1110701

History

Preferred citation

Nithianandan, N., Gibson-Helm, M., McBride, J., Binny, A., Gray, K. M., East, C. & Boyle, J. A. (2016). Factors affecting implementation of perinatal mental health screening in women of refugee background. Implementation Science, 11(1), 150-. https://doi.org/10.1186/s13012-016-0515-2

Journal title

Implementation Science

Volume

11

Issue

1

Publication date

18/11/2016

Pagination

150

Publisher

Springer Science and Business Media LLC

Publication status

Published

Online publication date

18/11/2016

ISSN

1748-5908

eISSN

1748-5908

Article number

150

Language

en