Partnering for Mental Health Promotion: Implementing Evidence Based Mental Health Services Within a Maternal and Child Home Health Visiting Program

This article details the clinical foundations of a social work focused community-based participatory research project promoting women’s mental health during and around the time of pregnancy. Specifically, we discuss the theoretical, empirical and organizational implementation of an enhanced engagement model of mental health service delivery that integrates evidenced based practices into the structure and services of an existing non-profit maternal and child health home visiting agency. The model is grounded in literature addressing barriers to accessing mental health care among minority women living in low-income communities. We discuss informing the intervention through direct consumer involvement, as well the rationale supporting the inclusion of Interpersonal Psychotherapy and Cognitive Behavioral Therapy into the design and implementation of the model which emphasizes adequate training of staff with varying levels of mental health experience. Finally, we describe typical client situations and responses reflected by the Enhanced Engagement model and discuss future implications of this approach as a way to offer meaningful intervention to women and families who may not have access or eligibility to utilize specialty mental health services

Racial Disparities in the Association Between Stress and Preterm Birth

Background: High levels of maternal stress have been linked to preterm births. However, findings from previous studies are inconsistent due to the varied use of stress measures. This study examined the effect of maternal stress on preterm birth, using both psychosocial and physiological measures. Methods: This study was conducted among 231 pregnant women enrolled during their first prenatal care visit. Presence of stress was assessed at enrollment using the Perceived Stress Scale (PSS) and Stressful Life Events Inventory (SLEI). Samples of maternal salivary cortisol were obtained during the first trimester and birth outcomes were ascertained at delivery. Multiple logistic regression was conducted to assess the association between stress and preterm birth. Results: The majority of the study participants were Black, not married, less educated and low income. There was an association between cortisol level and preterm birth. Per 1µg/dL increase in cortisol level, the odds of preterm birth increased by 26%. The increase was accentuated in Blacks where a unit increase in cortisol level was associated with higher odds of preterm birth (29%). Conclusions: Stress measures using PSS and SLEI did not reveal a statistically significant association with preterm birth. Health care and public health professionals should be aware of the association between increased cortisol level and preterm birth. Salivary cortisol may be a better predictor of preterm birth than PSS and SLEI

Partnership Process Guidelines: Social Work Perspectives on Creating and Sustaining Real-World University-Community Partnerships

The authors, representing community practitioners, faculty, students, and administration, collaborated to produce guidelines for university-community partnerships that reflect social work’s commitment to social justice in practice, education, and research. The respective experiences and voices of the authors contribute to a wider perspective on the explicit social justice implications of partnership formation for community-based participatory research, which is a vision shared by many disciplines. These guidelines introduce a communication outline that may augment the creation and maintenance of thriving university-community partnerships across multiple disciplines that promote social justice

Daily life or diagnosis? Dual perspectives on perinatal depression within maternal and child health home visiting

This study describes a qualitative inquiry-informing program development in a maternal and child home visiting program. Low-income women\u27s perceptions of the meaning and experiences of depression were ascertained through focus groups and interviews. Simultaneously, the study examines staff member perceptions and roles related to depression. Specific findings from clients and staff reveal culturally situated beliefs about depression and stressful life events; comparing and contrasting these beliefs offers a novel perspective on identification and intervention for maternal depression. This study offers a foundation for a translational research agenda that will be used for program and policy development to enhance mental health services situated within maternal and child health home visiting programs. © 2013 Copyright Taylor and Francis Group, LLC

Integrating behavioral health risk assessment into centralized intake for maternal and child health services

Effectively promoting women\u27s health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timelylinkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screen in gas wellas guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs