Date of Award

Spring 5-23-2020

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Martha G. Fuller, PhD, PPCNP-BC



Background: Postpartum depression (PPD) is estimated to affect up to 1 out of 7 women. Evidence and American Academy of Pediatrics (AAP) guidelines support maternal screening for PPD in a pediatric setting during well-child visits. The pediatric office is frequently visited during the first year of life and is a suitable setting to perform screening.

Aims of Service Change: Implement AAP recommended PPD screening at a busy primary care practice in Southern California using the Patient Health Questionnaire (PHQ-9).

Details of Innovation: In this pilot project, mothers (who were not patients of the pediatric practice) consented to be screened for PPD using the PHQ-9 at 1,2,4, & 6 month well child visits. All mothers were supplied resource material on PPD and community resources. Those whose scores put them at risk for PPD were referred to community providers for mental health services. For safety purposes, resources were identified prior to implementation and a plan was in place in the event a woman was actively suicidal. The theoretical models used to drive this project were the ACE-Star Model and Lewin's Change Theory.

Outcomes: During the two-month pilot, 81 mothers were eligible for screening; 23 women, or 28% completed the screening. Three were high-risk and were referred to community providers for services. The remaining were not screened because the mother did not complete the PHQ-9. The pediatric primary care provider has an opportunity to identify PPD early and provide support and referral for appropriate services