OB CARES - The Obstetric Clinics and Resources Study: Providers' perceptions of addressing perinatal depression - a qualitative study

Christie Lancaster Palladino*, Gina L. Fedock, Jane H. Forman, Matthew M. Davis, Erin Henshaw, Heather A. Flynn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective: We conducted a qualitative study to understand how prenatal care providers perceive influences on their delivery of perinatal depression care. Given that depression screening protocols were in place at the clinics where we sampled providers, we hypothesized that clinic- and system-level factors such as resources, training opportunities and coordination would be dominant in influencing provider decisions. Methods: We conducted semistructured interviews with 20 prenatal care providers from six obstetric clinics. We performed a thematic analysis, including within-case and cross-case comparisons, and built a conceptual model of provider decision making from the data. Results: Although depression screening protocols were in place at our study clinics, we found that decisions to address perinatal depression were largely made at the level of the individual provider and were undefined on a clinic level, resulting in highly variable practice patterns. In addition, while providers acknowledged externally derived influences, such as logistical resources and coordination of care, they spoke of internally derived influences, including familiarity with consultants, personal engagement styles and perceptions of role identity, as more directly relevant to their decision making. Conclusion: Our results highlight the pivotal role of internal factors in decisions to deliver perinatal depression care. Future interventions in obstetric settings should target the intrinsic motivations of providers.

Original languageEnglish (US)
Pages (from-to)267-278
Number of pages12
JournalGeneral Hospital Psychiatry
Volume33
Issue number3
DOIs
StatePublished - May 1 2011

Keywords

  • Obstetricians
  • Perinatal depression
  • Qualitative

ASJC Scopus subject areas

  • Psychiatry and Mental health

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