Postpartum depression, experienced by one in seven mothers in the United States, is more than twice as common among low-income women, according to a press release from Michigan State University. Researchers from Michigan State and the University are now studying how a program shown to help prevent postpartum depression might be implemented in clinics that “serve at-risk populations” across the country.
The program, called ROSE (Reach Out, stay Strong, Essentials for motions of newborns), was developed by Caron Zlotnick, a researcher at Care New England and research professor in the department of psychiatry and human behavior. Funded by the National Institutes of Health, the study aims to examine what would be required to sustain the program on a larger scale as part of “implementation research.”
The researchers are working with 90 clinics in six states to see how they can best adapt the program, said Jennifer Johnson MA’13, co-author of the study, adjunct associate professor of psychiatry and human behavior and professor of psychiatry and behavioral medicine at Michigan State.
Risk factors for postpartum depression include a history of depression, exposure to traumatic experiences and stressful life events, Johnson said. “For example: not having enough food to eat, not being able to get transportation, having conflict with your partner or not enough social support.”
Among financially disadvantaged women, strong social support has been found to limit negative stress reactions, Zlotnick wrote in an email to The Herald. “Empirical studies corroborate that greater social support is associated with lower depressed mood in perinatal financially disadvantaged women,” she wrote.
Studies suggest that women with fewer financial resources have both more stress and less familial support, which are both risk factors for developing postpartum depression, wrote Amy Salisbury, associate professor of psychiatry and human behavior, in an email to The Herald. There is a general consensus that treatment of a mother’s depression is the best way to mitigate and prevent its negative effects on their child’s development, she added.
ROSE “was developed because there were few interventions that demonstrated significant reduction in cases of postpartum depression and few, if any, studies (that) included women who were financially disadvantaged,” Zlotnick wrote.
The ROSE program consists of four in-person sessions, followed by a phone call after the baby has been born, Johnson said. It is an educational program, rather than a mental health treatment, that teaches women coping skills and helps them build a social support system.
In five clinical trials, groups that underwent the ROSE program saw fewer individuals experience postpartum depression than the groups that did not, Johnson said.
Prior to the research that is currently being conducted on the implementation of ROSE, the program had been studied in five clinical settings in Rhode Island, as well as in Mississippi and throughout prenatal clinics in Japan, Zlotnick wrote.
By bringing the ROSE program to 90 new clinics, the researchers hope to get a better understanding of what it will take to sustain the program on a larger scale. They plan to develop a sustainability plan and train clinics to implement the program and navigate operational logistics such as billing by July, Johnson said.
“It doesn’t help to have effective interventions if they’re not used,” Johnson said, adding that it’s important to know what helps an intervention program like ROSE sustain long-term influence and continue to be implemented, especially in clinics which might not have many resources.
Salisbury wrote that she is “pleased to hear that the intervention has been successful in clinical trials and is being prepared for wide-range use in other locations. Prevention of depressive illness in pregnancy and postpartum should be the goal, to prevent any potential influences on development.”
Women considering pregnancy or who are already pregnant and have a history of depression should explore the resources available to them or consult with a perinatal mental health specialist to know what their options are, Salisbury added.
Johnson emphasized that postpartum depression is common, and support is available to those who experience it.
