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document
The use of the Antenatal Psychosocial Health Assessment ( ALPHA ) tool in the detection of psychosocial risk factors for postpartum depression : a randomized controlled trial . OBJECTIVE Eliciting known risk factors for postpartum depression ( PPD ) during pregnancy may enable primary health care providers to identify women at increased risk of becoming depressed . The purpose of this study was to examine how well the Antenatal Psychosocial Health Assessment ( ALPHA ) form identified antenatal risk factors for PPD , compared with routine care , in a sample of pregnant women . METHODS A randomized controlled trial was conducted to assess the effectiveness of the ALPHA form in detecting antenatal risk factors associated with the adverse postpartum outcomes of postpartum depression , intimate partner violence , child abuse , and couple dysfunction . The participants were primary antenatal care providers -- family physicians , obstetricians , and midwives -- from four diverse communities in Ontario . These providers were matched and then randomly allocated into the intervention group , who used the ALPHA form , or into the control group , who administered usual care . In total , 227 pregnant women were recruited : 98 in the ALPHA group and 129 in the control group . The data presented in this paper are from a secondary analysis focusing on PPD as the outcome . RESULTS Providers randomized to the ALPHA group identified a statistically significantly higher proportion of women with antenatal psychosocial risk factors for PPD ( 36 % vs. 26 % ) and a significantly higher number of risk factors per woman compared with the control group ( mean 2.1 vs.1.8 ) ( z = -1.96 , P = 0.05 ) . Providers in the ALPHA group also identified significantly more women having a " previous history of depression " ( 16 % vs. 6 % ) ( chi2 = 5.243 , df = 1 , P = 0.03 ) and " [ having ] witnessed or experienced abuse as a child " ( 17 % vs. 3 % ) ( chi2 = 12.488 , df = 1 , P = 0.0005 ) , which are both established risk factors for PPD . CONCLUSION The ALPHA provides a systematic means of eliciting antenatal psychosocial risk factors for PPD for primary care providers , and it may be particularly useful for raising and discussing sensitive issues . The detection of depressive symptomatology during pregnancy remains problematic , however , and detection may be improved by administering a simple standardized measure of depressive symptomatology during routine antenatal care .
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Intervention_Educational
Antenatal Psychosocial Health Assessment ( ALPHA ) tool
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Intervention_Educational
Antenatal Psychosocial Health Assessment ( ALPHA )
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Intervention_Educational
ALPHA
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Intervention_Educational
matched and then randomly allocated into the intervention group
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Intervention_Educational
who used the ALPHA form
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Intervention_Educational
the control group , who administered usual care
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Intervention_Educational
ALPHA
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Intervention_Educational
ALPHA
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Outcome_Mental
psychosocial risk factors
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Outcome_Mental
risk factors for postpartum depression
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Outcome_Mental
effectiveness of the ALPHA
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Outcome_Physical
postpartum depression
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Outcome_Physical
intimate partner violence
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Outcome_Physical
child abuse
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Outcome_Physical
couple dysfunction
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Outcome_Mental
antenatal psychosocial risk factors for PPD
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Outcome_Mental
risk factors
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Outcome_Mental
previous history of depression
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Outcome_Mental
[ having ] witnessed or experienced abuse as a child
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Outcome_Physical
PPD
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Outcome_Mental
depressive symptomatology
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Participant_Sex
women
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Participant_Condition
primary antenatal care providers
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Participant_Sample-size
227
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Participant_Sex
women
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Participant_Sample-size
98
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Participant_Sample-size
129