Researchers from Henry Ford Health, Michigan State University and Care New England Health System are collaborating on a $6.2 million mental health research grant from the National Institutes of Health to expand and further research a postpartum depression intervention and prevention program that is proven to save lives.
The grant is officially titled “The ROSE Scale-Up Study: Informing a decision about ROSE as universal postpartum depression prevention. ROSE stands for “Reach Out, Stand Strong, Essentials for New Mothers.
“This will be the first study to look at the effectiveness of postpartum depression among a general population of women and women screening negative for postpartum depression risk,” said Caron Zlotnick, PhD, one of two principal investigators on the grant. Zlotnick is also a Professor of Psychiatry at Brown University and Director of Women’s Health Research at the Care New England Health System.
“If we find the expanded intervention is effective, we can work to scale up the program, strengthen families while supporting moms, and reduce costs within the healthcare system,” she said.
ROSE is a four-session class given to moms at risk of postpartum depression. Five clinical trials have shown that ROSE prevents half of the cases of postpartum depression among at-risk women.
The grant will support the expansion of the program and help researchers determine if all pregnant women or only those at high risk should be given the opportunity to participate.
One in four at-risk women may experience depression symptoms after each birth. Maternal mental health is a critical public health component of perinatal care and maternal safety. Postpartum depression can have lasting consequences for the mother, child and family.
Henry Ford Health will offer ROSE to all pregnant patients by adding the evidence-based postpartum depression prevention class to its Childbirth Education offerings.
Amy Loree, PhD, Assistant Scientist at Henry Ford Health, will serve as study site co-investigator on the project.
“We’re very excited to be collaborating with the study team and to be able to offer this preventive service to our patients,” Dr. Loree said. “Improving perinatal mental health care through effective prevention approaches such as ROSE is critical to improving health and wellbeing for birthing people and their families.”
Jennifer Johnson, PhD, C. S. Mott Endowed Professor of Public Health at Michigan State University College of Human Medicine and one of two PIs on the grant, said “postpartum depression causes suffering for mothers and can slow child development."
“The U.S. Preventative Services Task Force recommends that women at risk for postpartum depression receive these preventive interventions. However, our experience scaling up ROSE across the country suggests that a universal intervention may be better; easier for agencies, less stigmatizing for mothers, and no one is missed,” Johnson said.
Drs. Johnson and Zlotnick have been studying how best to implement and sustain ROSE nationally. They have found that most of the 98 healthcare and community agencies in their current study find it more feasible to provide postpartum depression as universal prevention for all women.
Postpartum depression is a common and detrimental public health concern. The postpartum period places women at increased risk for a major depressive episode. No method of determining who is at risk is perfect. Offering ROSE to only women determined to be at risk may miss women who could benefit from ROSE.
“Women who already face societal stigma can fear the consequences of seeking mental health support,” Johnson said. “Utilizing a universal prevention model will help to reduce that stigma, remove barriers to help and make maternal mental health support available to every mom.”
This research project will assess the effectiveness, cost-outcome, equity and scalability of a universal (i.e., available to everyone) vs. selective (i.e., available to only moms determined to be at risk) postpartum depression prevention model using commonly available/existing screening tools.
ROSE has been recommended by the U.S. Preventative Services Task Force for women at risk for postpartum depression. The intervention is freely available to agencies and providers. The curriculum is highly structured, easy to learn, and available in Spanish and English. It does not require a mental health professional. ROSE can be offered in various settings, including prenatal clinics, doula organizations, home visiting programs and WIC agencies.
Kim North Shine / Henry Ford Health / 313-549-4995 / [email protected]
Jill Vondrasek / Michigan State University Division of Public Health / 810-600-9185 / [email protected]
Jennifer Johnson / C.S. Mott Endowed Professor of Public Health at Michigan State University / 810-600-5669 / [email protected]