Abstract
Background: Postpartum depression (PPD) is a significant mental health problem that is common in primary care and often under-recognized and under-treated.
Methods: We developed an educational website (www.step-ppd.com) to give primary care providers easy access to up-to-date information on PPD and evidence-based approaches for assessing and treating PPD. Three web-based modules include didactic information, case studies, interactive video clips, and links to additional resources.
Results: The Support and Training to Enhance Primary Care (STEP)-PPD website is a new and valuable resource for primary care providers that can be easily accessed online and provides accurate and current information on best practices for evidence-based management of PPD in primary care settings.
Conclusion: The STEP-PPD website is publicly available and free of charge. To register for and view the program, visit www.step-ppd.com.
Postpartum depression (PPD) is a serious mental health problem that is under-recognized and under-treated in the United States.1–3 Primary care settings are an ideal context in which to identify women at risk, and many providers are routinely screening for PPD. However, the effects of this screening are mitigated by limited training in the screening and treatment of PPD. For example, in one survey, 70% of family physicians reported routinely screening women at 6 weeks postpartum, but only 18% used a validated screening tool specifically designed for PPD.4 Moreover, to positively impact clinical outcomes, screening must be followed by evidence-based depression management, including accurate diagnosis and appropriate treatment and follow-up.5
To help fill this significant knowledge gap, in 2004 the National Institute of Mental Health solicited contract proposals through its Small Business Innovation Research program to develop for primary care providers training materials about the detection and treatment of PPD. This report describes a web-based training program developed under this solicitation, now publically available and free of charge.
Description of the Web-Based Training Program
Support and Training to Enhance Primary Care for Postpartum Depression (STEP-PPD)6 is a web-based training program designed to educate primary care providers about evidence-based screening, diagnosis, treatment, and referral for PPD. The primary goal is to increase providers’ general knowledge about these elements of PPD. STEP-PPD also supports providers in implementation of evidence-based approaches for management of PPD in clinical practice. The target audience of STEP-PPD includes primary care providers across several fields. At registration, users are prompted to input information about their field (eg, family medicine, pediatrics, obstetrics/gynecology); profession (eg, physician, nurses, social workers, physician assistant); and many relevant special patient population characteristics (eg, race/ethnicity, residence in a rural region, adolescent mothers, women who used assisted reproductive technologies or gave birth to multiples). The content of the web-based training program is then customized for the user based on these variables.
The Web-based program contains the following 3 modules. (1) Understanding PPD presents information about the symptoms, etiology, and impact of PPD among women of different cultures, ethnicities, and geographic locations. The information reflects empirical research and clinical experience and serves as an introduction to PPD and other postpartum emotional difficulties. (2) Assessing PPD provides information and resources needed to implement evidence-based screening and assessment for PPD. Recommended approaches are designed to overcome common challenges faced by providers, including limited time for patient visits, competing time demands, and lack of adequate resources. (3) Treating PPD covers the guidelines for treatment of PPD in primary care settings using pharmacological and nonpharmacological interventions.
Each module provides detailed learning objectives, multiple case studies, interactive video clips, and links to additional resources. Case studies depict patient scenarios typically encountered in practice, and interactive video clips model provider interactions with postpartum women. In an effort to support implementation of evidence-based management practices, downloadable and printable resources such as patient education materials, screening tools with parameters for scoring, as well as techniques for engaging patients, are included. Although the web-based training is publicly accessible and free of charge, Continuing Medical Education units and some supplementary products (eg, personal digital assistant and print versions of a Clinician's Pocket Guide) are available for a small fee.
To register for and view the program, visit www.step-ppd.com.6
Acknowledgments
The authors thank Adam Haim, PhD, of the National Institute of Mental Health, and Enid Light, PhD, before him, for support and guidance throughout this project.
Notes
This article was externally peer reviewed.
Funding: This project has been funded in whole with Federal funds from the National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, under contract number HHS-N-278-2005-54995-C.
Conflict of interest: none declared.
- Received for publication December 30, 2008.
- Revision received April 29, 2009.
- Accepted for publication May 1, 2009.
