Introduction
depression
In 2016, the US Preventive Services Task Force (USPSTF) updated its recommendation to screen adults for depression in primary care,A range of approaches have been deployed to provide these supports: staff to facilitate referrals, nurse specialists for formal assessment, brief intervention and referral, or team-based collaborative care.We sought to compare the effectiveness of 2 approaches to the initial management of depression among a screen-detected population of pregnant and postpartum persons. We compared immediate referral using an engagement-focused care coordination (EFCC) strategy with short-term management of symptoms using a manualized cognitive behavioral program called problem-solving education (PSE). Whereas EFCC provides referral to formal mental health services outside primary care, PSE offers a brief, on-site, evidence-based treatment, followed by referral to further treatment if symptoms persist. While both EFCC