부산대학교 도서관

Byline: Matthew Fifolt, Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham (Drs Fifolt and Preskitt and Mss Johnson and Enlow); Alabama Department of Early Childhood Education, Montgomery (Ms Tullier); and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Arbour).; Heather H. Johnson; Julie Preskitt; Margaret Enlow; Dianna Tullier; MaryCatherine Arbour Abstract BACKGROUND AND OBJECTIVES: From 2013 to 2017, a national Breakthrough Series (BTS) collaborative in Maternal, Infant, and Early Childhood Home Visiting programs developed a toolkit that led to improvements in maternal depression outcomes. In 2018, Alabama's home visiting program (First Teacher) aimed to reproduce these impacts with a state-led BTS that enrolled 8 local implementing agencies (LIAs) serving more than 500 families. METHODS: LIAs tested changes in practices using Plan-Do-Study-Act cycles and tracked data regarding depression screening, referrals, service access, and symptom improvement via run charts. First Teacher administered a post-collaborative survey to assess LIA team members' satisfaction with their BTS experience. RESULTS: Alabama's BTS resulted in positive shifts in maternal depression referrals, service access, and symptom improvement. Change ideas that supported these shifts included the use of a screening script, motivational interviewing, 'Mothers and Babies,' and a registry. LIAs noted that BTS tools and resources helped build capacity to address the difficult and frequently stigmatized topic of maternal depression. CONCLUSION: Findings from this study indicate that evidence- and experience-based practices regarding maternal depression screening, referrals, and service access can lead to symptom improvement among mothers enrolled in a state-based home visiting program. Results of this investigation corroborate findings from previous studies while also incorporating feedback from LIAs about the BTS experience.