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Factors affecting implementation of perinatal mental health screening in women of refugee background
journal contributionposted on 2022-03-23, 03:16 authored 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.
Improving pregnancy care for populations at risk in Australia | Funder: National Health and Medical Research Council | Grant ID: 1110701
Preferred citationNithianandan, 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 titleImplementation Science
PublisherSpringer Science and Business Media LLC
Online publication date2016-11-18
CategoriesNo categories selected
AnxietyDepressionHealth services researchMental healthPerinatalPost-traumatic stress disorderPregnancyPrenatal careRefugeesAttitude of Health PersonnelAttitude to HealthClinical CompetenceDelivery of Health CareFemaleHealth Knowledge, Attitudes, PracticeHumansMental DisordersPerinatal CarePregnancy ComplicationsSelf ConceptSocial SupportVictoriaBehavioral and Social ScienceHealth ServicesPost-Traumatic Stress Disorder (PTSD)PreventionMental HealthClinical Research8.1 Organisation and delivery of servicesReproductive health and childbirthInformation and Computing SciencesMedical and Health SciencesHealth Policy & Services