Intervention Conditions
depression, psychiatric
MomCare is a culturally relevant, collaborative care intervention that provides brief IPT.All IPT therapists and collaborative care team members completed a 3-day training and were certified by Nancy Grote, PhD, a leading brief IPT expert for antenatal depression. IPT therapists were doctoral-level clinicians who followed detailed treatment manuals and received supervised training. Adherence checklists ensured that MOMCare was delivered with fidelity. Fidelity ratings were very high (mean, 1.90; scale ranged from 0 [needs work] to 2 [done well]) across sessions independently rated by MOMCare developers Nancy Grote, PhD, and Mary C. Curran, MSW. All participants had at least 1 session reviewed; 25% to 40% of sessions across active IPT were reviewed (eMethods 2 in EUC augmented the usual standard of care pregnant individuals received within OB/GYN clinics through their obstetric clinicians and/or social workers. EUC consisted of maternity support services, which provides mental health counseling integrated within the obstetric setting and 1-on-1 consultation session with doctoral-level clinicians. Through maternity social services, pregnant individuals were offered mental health support, based on patient preferences, including prepartum depression care (eclectic counseling [not IPT or cognitive behavioral therapy] or psychiatric consultation including medication) and other community services. During this 1-on-1 sixty-minute consultation session, the clinician reviewed written psychoeducational materials on perinatal depression so participants could better recognize mood symptoms during pregnancy and discussed with the participant ways to talk with partners or other supports about depression to elicit help. Clinicians conducted ongoing monitoring with participants and provided referrals to patients to overcome barriers and when care was needed. Extensive community resources were provided, including information on additional alternative community mental health and counseling services, essential items and housing programs, and local resource centers for pregnancy and postpartum support. Overall, 58 participants (48.8%) reported using additional counseling. EUC occurred during the same time frame as MOMCare.