Evidence map›Paper›PMID 34271852›Full record

ArticleBMC pregnancy and childbirth2021

Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups.

Esti Iturralde, Crystal A Hsiao, Linda Nkemere, Ai Kubo, Stacy A Sterling, Tracy Flanagan, Lyndsay A Avalos

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 2 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Esti IturraldeDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA. estibaliz.m.iturralde@kp.org.
Crystal A HsiaoDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Linda NkemereDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Ai KuboDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Stacy A SterlingDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Tracy FlanaganThe Permanente Medical Group, Oakland, CA, USA.
Lyndsay A AvalosDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Kaiser Permanente · USColorado Permanente Medical Group · US

Funding

mHealth Mindfulness Intervention for Pregnant Black and Latina Women at Risk of Postpartum DepressionR01MH126580 · NIMH · KAISER FOUNDATION RESEARCH INSTITUTE · PI AVALOS, LYNDSAY AMMON, KUBO, AI · 2021 to 2023
$3.4M
NIMH NIH HHS R01 MH126580
6 · The paper itself

Abstract

backgroundTo better understand previously observed racial/ethnic disparities in perinatal depression treatment rates we examined care engagement factors across and within race/ethnicity.

methodsObstetric patients and women's health clinician experts from a large healthcare system participated in this qualitative study. We conducted focus groups with 30 pregnant or postpartum women of Asian, Black, Latina, and White race/ethnicity with positive depression screens. Nine clinician experts in perinatal depression (obstetric, mental health, and primary care providers) were interviewed. A semi-structured format elicited treatment barriers, cultural factors, and helpful strategies. Discussion transcripts were coded using a general inductive approach with themes mapped to the Capability-Opportunity-Motivation-Behavior (COM-B) theoretical framework.

resultsTreatment barriers included social stigma, difficulties recognizing one's own depression, low understanding of treatment options, and lack of time for treatment. Distinct factors emerged for non-White women including culturally specific messages discouraging treatment, low social support, trauma history, and difficulty taking time off from work for treatment. Clinician factors included knowledge and skill handling perinatal depression, cultural competencies, and language barriers. Participants recommended better integration of mental health treatment with obstetric care, greater treatment convenience (e.g., telemedicine), and programmatic attention to cultural factors and social determinants of health.

conclusionsWomen from diverse backgrounds with perinatal depression encounter individual-level, social, and clinician-related barriers to treatment engagement, necessitating care strategies that reduce stigma, offer convenience, and attend to cultural and economic factors. Our findings suggest the importance of intervention and policy approaches effecting change at multiple levels to increase perinatal depression treatment engagement.

Indexed as

EthnicityPerinatal CareAdultCaliforniaDepressionFemaleFocus GroupsHumansPatient Acceptance of Health CarePeripartum PeriodPostpartum PeriodPregnancyQualitative ResearchBehavioral health integrationCOM-BHealth equityPerinatal depressionRacial disparities

Identifiers

PMID34271852
PMCPMC8284181
OpenAlexW3183039027

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.