Session: Implementation of a Postpartum Depression Prevention Intervention in Multiple Settings (Society for Prevention Research 21st Annual Meeting)

Many interventions with demonstrated efficacy or effectiveness fail to yield similar outcomes when translated for use in new settings or with new populations.  This organized symposium will describe three studies that have translated a postpartum depression prevention intervention for use in different settings.  The postpartum depression prevention intervention—the Mothers and Babies (MB) Course—was found to reduce depressive symptoms during pregnancy and result in fewer new cases of major depressive episodes in two randomized clinical trials.  The first study in this organized paper symposium describes the adaptation of the MB Course for use in a Women, Infant, and Children (WIC) clinic co-located at a federally qualified health center in Washington, DC; WIC programs are estimated to serve half of all infants born in the United States.  The second study describes the adaptation of the MB Course for use in home visitation (HV) programs; it is estimated that about 500,000 women per year receive HV services.  In addition to describing their adaptation for HV, the authors present data on implementation feasibility and outcomes from a randomized controlled trial that demonstrate reduced depressive symptoms and fewer new major depressive episodes among perinatal women receiving the MB intervention.  The third study describes a web-adapted version of the MB Course and preliminary data from a pilot randomized controlled trial to test this adaptation’s efficacy.  Damschroder et al. (2009) established a Consolidated Framework for Implementation Research (CFIR) that outlines five key domains that influence effective intervention adaptation and implementation: (a) intervention characteristics, (b) outer setting [e.g., social, cultural context], (c) inner setting [e.g., features of social, cultural context through which implementation proceeds], (d) characteristics of individuals involved in implementation, and (e) process by which implementation is accomplished.  Each presenter will highlight key aspects of these different domains that were attended to in their respective adaptations of the MB Course.  Thus, along with presenting findings related to the feasibility and outcomes of each adapted intervention, presenters will also provide participants with key reflections on processes that facilitated the successful adaptation of the MB Course into a different setting.  Attempts to translate evidence-based interventions across different settings and contexts are challenging and must take into consideration the multiple domains that influence effective intervention implementation.  However, evidence-based interventions can have considerable reach when moving beyond the setting in which they were initially created, as evidenced by the three presentations in this organized symposium that are working in settings accessed by large numbers of perinatal women.