Implementing evidence-based practice: practitioner assessment of an agency-based training program.

Responding to the call for evidence-based practice (EBP) in social work, the authors conducted a multiphase exploratory study to test the acceptability of a training-based collaborative agency-university partnership strategy supporting EBP. The Bringing Evidence for Social Work Training (BEST) study includes an agency training component consisting of 10 modules designed to support the implementation of EBP in social agencies. Qualitative data from post-training participant focus groups were analyzed in order to describe practitioner perceptions of the 10 training modules and trainer experiences of implementation. Based on the findings from this study the authors suggest that the BEST training was generally acceptable to agency team members, but not sufficient to sustain the use of EBP in practice.

Intimate partner violence and depressive symptoms before pregnancy, during pregnancy, and after infant delivery: an exploratory study.

Women who experience intimate partner violence (IPV) during pregnancy also tend to experience depressive symptoms. Unfortunately, little is known about how victimized women's levels of depressive symptoms change longitudinally before pregnancy, during pregnancy, and after infant delivery. In addition, few studies have used a comparison group of women to determine if levels of depressive symptoms among victimized women differ from depressive symptom levels in women who have not experienced IPV. To help address these knowledge gaps, we examined longitudinal trends in levels of depressive symptoms among a sample of 76 women who did (n = 33) and did not (n = 43) experience physical IPV during pregnancy. Using multilevel analysis, we estimated the relationship of physical IPV victimization and women's depressive symptom levels across six time periods: (a) the year before pregnancy, (b) first and second trimesters, (c) third trimester, (d) the first month postpartum, (e) Months 2 to 6 postpartum, and (f) Months 7 to 12 postpartum. Women who experienced physical IPV victimization during pregnancy had significantly higher levels of depressive symptoms during each time period (p < .05). No significant difference between the two groups was found in the rate of change in levels of depressive symptoms over time. These findings point to the importance of screening for IPV within health care settings and suggest that women physically abused during pregnancy need safety interventions that are coordinated with interventions targeting symptoms of depression.

A prospective study of perinatal depression and trauma history in pregnant minority adolescents.

OBJECTIVE: Adolescent pregnancy is common and minority adolescents are at high risk. We sought the following: (1) to prospectively assess prevalence of antenatal depression (AND) and postpartum depression (PPD) in minority adolescents and (2) to examine the association of social support and adjustment, trauma, and stress on depression status. STUDY DESIGN: A total of 212 pregnant adolescents were recruited from public prenatal clinics and administered a prospective research survey during pregnancy and 6 weeks' postpartum. Depression was measured using the Edinburgh Postnatal Depression Scale. Univariate, bivariate, and multivariable analyses were performed using logistic regression to assess predictors of AND and PPD. RESULTS: In our cohort, 20% screened positive for AND and 10% for PPD. The strongest predictor of PPD was AND (odds ratio [OR], 4.89; P < .001). Among adolescents with trauma history, there was a 5-fold increase (OR, 5.01) in the odds of AND and a 4-fold increase (OR, 3.76) in the odds of PPD. AND was associated with the adolescent's poor social adjustment (P < .001), perceived maternal stress (P < .001), less social support (P < .001), and a less positive view of pregnancy (P < .001). PPD was significantly associated with primiparity (P = .002), poor social adjustment (P < .001), less social support and involvement of the baby's father (P < .001), and less positive view of pregnancy (P < .001). CONCLUSION: Significant independent risk factors for PPD include AND, view of pregnancy, and social support. Trauma history was highly prevalent and strongly predicted AND and PPD. Point prevalence decreased postpartum, and this may be due to transient increased social support following the birth, warranting longer follow-up and development of appropriate interventions in future work.

The influence of stress and social support on depressive symptoms in mothers with young children.

Limited research has examined the associations of stress, social support, and depression among mothers with young children over time. Longitudinal studies are needed to identify risk and protective factors for maternal depression given that depression can be cyclical and may affect women through the early years of their children's development. This study examined the relationships among stress, social support, and depressive symptoms in a national sample of low-income urban American women with young children. A secondary data analysis of the Fragile Families and Child Wellbeing Study, a national longitudinal panel study of nearly 5000 births across 20 cities with populations of 200,000 or more in the United States, was conducted. The analytic sample included all mothers (N = 3675) who completed assessments at baseline through year 5 of the study between 1998 and 2005. Multivariate models using generalized estimating equations were used to estimate the probability of being depressed as a function of stress-related risk factors, social support factors, and sociodemographic variables. The rate of depression each year ranged from 15% to 21%. The results suggest that stress related to economic hardship, parenting, and poor physical health increases the risk of depression among low-income urban mothers with young children. Instrumental and partner support were found to be potential protective factors in reducing the negative effects of stress, but only to a certain degree. Future efforts are needed to strengthen social support and mitigate chronic stressors that contribute to mental health problems in low-income communities.