Developing and Implementing Educational Resources to Address Perinatal Mental Health

“Since early in my research career, I have been focused on what we could do to ensure that every child has the best possible start in life. This led me to examine prevention and early intervention resources to promote healthy pregnancies and child outcomes.” 

Mental health conditions, including perinatal or maternal depression that occur during pregnancy and up to a year after delivery, are a leading underlying cause of pregnancy-related deaths in the United States. Children who were exposed to maternal depression during pregnancy more often show problems with behavior and cognition. They also are at higher risk of suffering from depression themselves later in life. 

Although a common and treatable health condition, perinatal depression often goes undetected and untreated. This is due, in part, to limited access to appropriate care and providers’ lack of knowledge and skills to manage this condition.

Jenn Leiferman, Ph.D., chair and professor in the Department of Community and Behavioral Health at the University of Colorado-Denver, focuses her research on perinatal and child mental health. For nearly 20 years, Dr. Leiferman has used AHRQ funding to develop and test educational interventions and strategies to address perinatal mental health. She has good news to report: “Recently, researchers have begun focusing more on the mental health of individuals during pregnancy instead of focusing solely on postpartum depression.”  

In 2005, Dr. Leiferman received a 1-year AHRQ small research grant to survey pediatricians, obstetricians, and family medicine practitioners on their attitudes, beliefs, and practices related to the management of maternal depression. “Unfortunately, 20 years ago, despite opportunity and relevance, many providers did not diagnose and treat maternal depression,” Dr. Leiferman said. Her study found that more than 90 percent of the 217 physicians surveyed reported that it was their responsibility to recognize maternal depression; however, a large percentage of physicians rarely or never assessed for depression (40 percent) or provided a mental health specialist referral (66 percent). These findings helped guide her development of intervention strategies to enhance physicians’ skills in managing maternal depression in primary care settings.

In 2010, Dr. Leiferman received a 2-year AHRQ small research grant to help her better understand healthcare providers' attitudes, beliefs, perceived barriers, and then-current practices related to antenatal or prenatal (during pregnancy) physical activity counseling. She found that while the majority of the providers surveyed agreed that prenatal physical activity would result in improved health outcomes for mother and baby, nearly half of those providers were not familiar with the specific recommendation from the American College of Obstetricians and Gynecologists that women without obstetric complications should engage in at least 150 minutes of exercise per week. Also, a majority of providers believed that overweight and/or sedentary pregnant women would be uncomfortable talking about physical activity and that they would not follow their advice to start engaging in antenatal physical activity.

Building on her previous study, Dr. Leiferman received a third AHRQ small research grant in 2014 to develop a web-based platform (Word, 29 KB) to assist and encourage providers to talk to patients about the benefits of prenatal physical activity. “Women who are pregnant engage in less regular physical activity than their nonpregnant counterparts,” Dr. Leiferman said. Her 2-year study aimed to ensure that healthcare providers had adequate knowledge and skills in this critical area.

With a fourth AHRQ small research grant in 2018, Dr Leiferman’s 2-year project tested a brief online training program aimed at improving patient-provider communication about prenatal depression. Findings from the study suggest that the training may enhance the likelihood of providers screening, treating, and/or referring at-risk patients for prenatal depression and follow-up care. 

“Through my AHRQ-funded research, I’ve been able to examine data, develop evidence-based interventions, and make changes to promote healthy outcomes for parents and children,” Dr. Leiferman said.

Principal Investigator: Jenn Leiferman, Ph.D. 
Institution: University of Colorado-Denver 
Grantee Since: 2005 
Type of Grant: Small Research Grants

Related AHRQ Resources

• AHRQ Safety Program for Perinatal Care: Experiences From The Frontline (PDF, 1.7 MB).
• Maternal Care.
• Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions.