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Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application.
Arch Womens Ment Health. 2014 Oct; 17(5):423-31.AW

Abstract

Randomized controlled trials conducted in resource-limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment, lay health workers can be trained to effectively administer psychological treatments. We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones. Pregnant, Xhosa-speaking women were recruited independently in two cross-sectional studies (N = 1,144 and N = 361) conducted in Khayelitsha, South Africa and assessed for antenatal depression. In the smaller study, community health workers with no training in human subject research were trained to administer the Edinburgh Postnatal Depression Scale (EPDS) during the routine course of their community-based outreach. We compared the operating characteristics of four short and ultrashort versions of the EPDS with the criterion standard of probable depression, defined as an EPDS-10 ≥ 13. The prevalence of probable depression (475/1144 [42 %] and 165/361 [46 %]) was consistent across both samples. The 2-item subscale demonstrated poor internal consistency (Cronbach's α ranged from 0.55 to 0.58). All four subscales demonstrated excellent discrimination, with area under the receiver operating characteristic curve (AUC) values ranging from 0.91 to 0.99. Maximal discrimination was observed for the 7-item depressive symptoms subscale: at the conventional screening threshold of ≥10, it had 0.97 sensitivity and 0.76 specificity for detecting probable antenatal depression. The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression.

Authors+Show Affiliations

Center for Global Health and Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA, actsai@partners.org.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24682529

Citation

Tsai, Alexander C., et al. "Antenatal Depression Case Finding By Community Health Workers in South Africa: Feasibility of a Mobile Phone Application." Archives of Women's Mental Health, vol. 17, no. 5, 2014, pp. 423-31.
Tsai AC, Tomlinson M, Dewing S, et al. Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application. Arch Womens Ment Health. 2014;17(5):423-31.
Tsai, A. C., Tomlinson, M., Dewing, S., le Roux, I. M., Harwood, J. M., Chopra, M., & Rotheram-Borus, M. J. (2014). Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application. Archives of Women's Mental Health, 17(5), 423-31. https://doi.org/10.1007/s00737-014-0426-7
Tsai AC, et al. Antenatal Depression Case Finding By Community Health Workers in South Africa: Feasibility of a Mobile Phone Application. Arch Womens Ment Health. 2014;17(5):423-31. PubMed PMID: 24682529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application. AU - Tsai,Alexander C, AU - Tomlinson,Mark, AU - Dewing,Sarah, AU - le Roux,Ingrid M, AU - Harwood,Jessica M, AU - Chopra,Mickey, AU - Rotheram-Borus,Mary Jane, Y1 - 2014/03/30/ PY - 2013/07/01/received PY - 2014/03/04/accepted PY - 2014/4/1/entrez PY - 2014/4/1/pubmed PY - 2015/5/16/medline SP - 423 EP - 31 JF - Archives of women's mental health JO - Arch Womens Ment Health VL - 17 IS - 5 N2 - Randomized controlled trials conducted in resource-limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment, lay health workers can be trained to effectively administer psychological treatments. We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones. Pregnant, Xhosa-speaking women were recruited independently in two cross-sectional studies (N = 1,144 and N = 361) conducted in Khayelitsha, South Africa and assessed for antenatal depression. In the smaller study, community health workers with no training in human subject research were trained to administer the Edinburgh Postnatal Depression Scale (EPDS) during the routine course of their community-based outreach. We compared the operating characteristics of four short and ultrashort versions of the EPDS with the criterion standard of probable depression, defined as an EPDS-10 ≥ 13. The prevalence of probable depression (475/1144 [42 %] and 165/361 [46 %]) was consistent across both samples. The 2-item subscale demonstrated poor internal consistency (Cronbach's α ranged from 0.55 to 0.58). All four subscales demonstrated excellent discrimination, with area under the receiver operating characteristic curve (AUC) values ranging from 0.91 to 0.99. Maximal discrimination was observed for the 7-item depressive symptoms subscale: at the conventional screening threshold of ≥10, it had 0.97 sensitivity and 0.76 specificity for detecting probable antenatal depression. The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression. SN - 1435-1102 UR - https://www.unboundmedicine.com/medline/citation/24682529/Antenatal_depression_case_finding_by_community_health_workers_in_South_Africa:_feasibility_of_a_mobile_phone_application_ L2 - https://dx.doi.org/10.1007/s00737-014-0426-7 DB - PRIME DP - Unbound Medicine ER -