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MIP: Implementing Postpartum Depression Screening in Rural Michigan WIC Clinics

October 2019 - September 2020

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a public assistance program providing food, nutrition education and counseling, health care referrals, and breastfeeding support to low-income pregnant, postpartum, and breastfeeding women and children from birth to age 5. Women and children who receive Medicaid are automatically income eligible for WIC services. In 2017, WIC served over 7 million women and children nationwide. Each month, more than 200,000 women and children receive WIC in Michigan. WIC clinics are where low-income postpartum women naturally go for food and nutrition services during a time when they are at high risk for PPD. Thus, WIC clinics may be a promising site for administering PPD screening in rural communities and increasing access to PPD screening for rural women receiving Medicaid. Further, WIC staff, including nurses and nutritionists, are well-positioned to be trained to administer and interpret PPD screening tools and provide appropriate referrals. Although WIC clinics offer a potentially promising setting to initiate PPD screening in rural communities, it is essential to assess barriers and facilitators to PPD screening. Identifying barriers and facilitators to PPD screening allows us to understand whether screening is feasible and acceptable in this setting and informs the design of relevant, context-specific implementation strategies for initiating PPD screening. The proposed implementation research will be guided by the Theoretical Domains Framework (TDF), a consolidated theoretical framework identifying domains related to behavior change . The TDF provides a lens for identifying cognitive, affective, social, and environmental influences on behaviors, which in turn inform behavior change targets for implementation interventions.

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