Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.
Patient Population: Perinatal (pregnant and new moms)
Moms’ Access Project ECHO: Perinatal Psychiatry Case Conference Series
Perinatal Psychiatry Case Conference Series is a CME-accredited program for providers in Washington State who want to improve the mental health of their pregnant and postpartum patients.
Facilitated by a multidisciplinary team including UW Medicine perinatal psychiatrists, obstetrician gynecologists, maternal fetal medicine experts, advanced registered nurse practitioners, therapists and social workers, the program aims to increase frontline provider capacity to address common mental disorders in pregnancy and postpartum. Program format is brief didactic followed by in depth case presentation and discussion.
Developing a tailored implementation plan for Collaborative Care of perinatal depression care in Community Health Centers in Vietnam
Perinatal depression is a common and serious disorder, with suicide representing a major cause of maternal mortality, but few women from low and middle income countries (LMICs) receive effective treatment. Effective models of care that improve perinatal depression and support suicide prevention exist but have not yet been widely implemented in routine maternal-child care services in LMICs. We plan to use a participatory approach to systematically identify and adapt key elements of evidence based models of perinatal depression care delivery to the cultural and health services context of Can Tho, Vietnam. Simultaneous exploration of potential implementation strategies to support and sustain this model in context will be identified along with the creation of a training and implementation toolkit for this setting. Using these strategies and tools we will then carry out a pilot perinatal collaborative care study in a public health center and the prenatal care practice of the Can Tho Obstetric and Gynecologic Hospital. The results of this pilot will be used to revise and enhance the treatment model and related implementation tools. These will be used in subsequent trials of effectiveness and/or implementation broadly in the health care system of Can Tho.
Perinatal PCL
The Perinatal Psychiatry Consultation Line (PCL) is a free telephone consultation service for health care providers caring for patients with mental health problems who are pregnant, postpartum, or planning pregnancy. Any health care provider in Washington State can receive consultation, recommendations, and referrals to community resources from a UW psychiatrist with expertise in perinatal mental health.
Maternal-Infant Dyad Implementation (MInD-I)
The MInD-I study targets improving dissemination of the evidence based Collaborative Care treatment model for pregnant and postpartum women with depression. Longitudinal remote consultation (LRC) is an implementation strategy that has been have shown to improve fidelity to evidence-based practices and patient outcomes for mental health innovations. The investigators believe LRC can be used with equal benefit for complex interventions such as CC.
The purpose of this study is to compare two implementation strategies for Collaborative Care depression treatment: 1) standard implementation and 2) standard implementation + Longitudinal Remote Consultation (LRC). This research is being done in order to assess implementation and patient outcomes in sites receiving a standard implementation approach with and without LRC. The results of the proposed study will provide information on the benefits and relative value of ongoing consultation, such as LRC, for implementation of complex interventions like collaborative care.
