Integrated Infant Mental Health (I-IMH) in Prenatal Care: Results From a Pragmatic Effectiveness-Implementation Pilot Trial

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Abstract

We have developed and present here initial pilot implementation data on the Integrated Infant Mental Health (I-IMH) in Prenatal Care model, which serves predominantly low-income, high-risk women during and after pregnancy through embedding a Master’s level behavioral health consultant with special training in Infant Mental Health (Fraiberg model) into obstetric medical clinics serving underserved communities. In collaboration with a community agency we have partnered with 11 obstetric clinics in Metro Detroit, and conduct a longitudinal pragmatic comparative effectiveness trial contrasting the I-IMH model of care (8 clinics) to treatment-as-usual (phone referral, 3 clinics). Women (total n=155; n=85 in I-IMH; n=70 TAU) were enrolled in early pregnancy (<20 weeks gestation) and followed up to 12 months postpartum providing interview and survey data (at 20 and 34 weeks gestation, 6 weeks, 6 and 12 months postpartum). Overall, we obtain patient, provider, system, and cost-level evaluation data, and contrast outcomes across I-IMH vs TAU. Demographically, the sample represents an at-risk population (77% minority, 85% annual family income <50K, 38% 4+ ACE score, 30% homeless). Preliminary analyses demonstrate that women enrolled in I-IMH sites show a drop in self-reported anxiety and depression, and increase in quality of life and social support from baseline assessment to 6 weeks postpartum, whereas women in the control sites do not. Data on 6 and 12 months outcomes as well as provider (focus groups), system (interviews with clinic managers and system administrators), and cost-level evaluation data are still being collected and will be presented at symposium.

Authors

• Maria Muzik, University of Michigan - Ann Arbor
  Presenting Author

• Katherine L Rosenblum, University of Michigan - Ann Arbor
  Non-Presenting Author

• Charity Hoffman, University of Michigan - Ann Arbor
  Non-Presenting Author