How a virtual newborn program can improve postpartum depression screening rates in disadvantaged communities

Study motivation
Rates of postpartum depression (PPD) screening in the United States are low. Only 11% of privately insured and 17% of Medicaid-insured mothers are screened. Interventions exist to address this gap, including the American Academy of Pediatrics (AAP) recommendation for pediatricians to screen patients during newborn appointments. With the influx of virtual support programs, we explored if they could close the PPD screening gap. We sought to answer two questions:
- To what extent does a virtual newborn support program effectively screen parents for PPD?
- Does the program screen parents at similar rates across geographies, as defined by social deprivation index (SDI)?
Methodology
- A retrospective review of 203 charts from Included Health’s virtual newborn support program between June 2021 and December 2023
- Clinicians reviewed the charts for evidence of an Edinburgh Postnatal Depression Scale (EPDS-3) screening, a positive PPD screen (score of >4), if the care team diagnosed the parent before a local care provider, and if PPD resources were shared
- Proportions were compared by zip code SDI quartiles using chi-square tests

What we found
- Among the 203 parents included in the study, 96% of parents were screened for PPD at least once. There were similar rates of PPD screening and PPD resources provided (97% on average) to parents across geographies.
- The positive screening rate was 33% overall, ranging from 29% in the fourth SDI quartile (area with highest deprivation) to 46% in the second SDI quartile.
- Among those with a positive PPD screening, 57% were identified by the virtual care team before an in-person provider. PPD was identified by the virtual care team before an in-person provider at higher rates for parents residing in areas with higher deprivation (71% for patients living in areas with highest deprivation vs. 57% overall).

Implications
- Our findings indicate that a virtual newborn support program can help fill a gap in postpartum care, specifically PPD screening
- Our findings support the American Academy of Pediatrics recommendation for payment of care management without an in-person encounter
Marshall JM, Thames T, McGuirl J. How a virtual newborn program can improve postpartum depression screening rates in disadvantaged communities. Poster presented at: Academy Health Annual Research Meeting; June 30, 2024; Baltimore, MD, https://vmx.m-anage.com/us/2024arm/en-US/presentation/653714