MOMCare: Culturally Relevant Treatment Services for Perinatal Depression
MOMCare: Culturally Relevant Treatment Services for Perinatal Depression
The study will evaluate the effectiveness of a culturally relevant, multi-component
 intervention for antenatal depression. The intervention includes an engagement session, and
 the woman's choice of brief interpersonal psychotherapy and/or pharmacotherapy in a stepped
 care treatment for depression model.
The randomized control trial will evaluate the effects of a culturally relevant,
 multi-component intervention for antenatal depression. MOMCare has the potential to overcome
 patient, provider, and system-level barriers to care and engage depressed, low-income women
 in evidence-based treatments to reduce antenatal depressive symptoms, improve maternal
 psychosocial functioning, and ameliorate postpartum depression. Specific Aim 1: To evaluate
 the impact of MOMCare on treatment engagement and retention. Specific Aim 2: To evaluate the
 impact of MOMCare on maternal clinical symptoms and functional outcomes. Specific Aim 3: To
 conduct an incremental cost-effectiveness analysis for a health care and welfare agency
 perspective that includes a) tracking the medical costs of health service use in MOMCare and
 usual care patients; b) monitoring the use of infant preventative health services in both
 groups; and c) tracking the percentage of women on Medicaid and the percentage working in
 both groups.

 The intervention will be assessed through a practical randomized controlled trial in which we
 have recruited 168 pregnant women with major depression and/or dysthymia who were on Medicaid
 and/or received Maternal Support Services (MSS) in selected public health centers in Seattle
 - King County (PHSKC). Patients who were eligible and consented to study enrollment were
 randomly assigned to either usual care (UC) or MOMCare. Baseline and four follow-up
 assessments (3 - 18 months post-baseline) are scheduled for study participants in both
 groups. The MOMCare intervention includes a choice of brief interpersonal psychotherapy or
 collaborative management of antidepressant medication. Treatment response will be monitored,
 and the treatment will be adjusted as necessary (adding treatments, increasing dosages).
Inclusion Criteria:

 -  18 or older

 -  pregnant: 12-32 weeks gestation

 -  able to speak English

 -  telephone access

 -  major depressive disorder or dysthymia

 -  on Medicaid

 -  receiving health care in King County, Washington

 Exclusion Criteria:

 -  currently in psychotherapy

 -  currently receiving pharmacotherapy from a psychiatrist

 -  high suicide risk

 -  history of bipolar disorder

 -  history of schizophrenia

 -  substance use or dependence in previous 3 months

 -  currently in a relationship with severe interpersonal violence

 -  history of repetitive self-harm behavior