PROJECT SUMMARY/ABSTRACT
Postpartum depression (PPD) is a non-psychotic depressive episode occurring after childbirth. PPD causes
enormous suffering and disability in new mothers, negatively impacting child care and development. Women
from lower socioeconomic status (SES) backgrounds are particularly vulnerable to developing PPD. The
negative impact of PPD on low-SES mothers is further compounded by limited access to mental health
services due to structural barriers and stigma toward mothers experiencing mental health conditions.
Specifically, low SES African American and Latina mothers are significantly less likely to seek mental health
services than their non-Hispanic white peers, making low-SES African American and Latina families more
vulnerable to the adverse health and developmental impacts of PPD.
One promising approach to addressing PPD among low-income mothers is home visiting. By delivering health
care directly to mothers in their residence, home visiting reduces many of the structural and cultural barriers
preventing new mothers from engaging with services for the prevention and treatment of PPD. Prior systematic
reviews on the effectiveness of service delivery via home visiting for PPD found mixed results, ultimately
concluding that there was insufficient evidence to support that the home visiting approach for service delivery
significantly improves maternal mental health. However, the two most recent systematic reviews only included
home visiting models that were delivered exclusively by nurses or midwives. The other two reviews were
conducted more than ten years ago. Since then, there has been a proliferation of new research on early
childhood home visiting programs. Moreover, the reviews published to date have not identified core
components associated with effective home visiting models for PPD intervention. Knowledge of core
components for success is critical for home visiting programs to address PPD more effectively and efficiently.
Accordingly, there remains a need to integrate the latest research to evaluate the overall effectiveness of home
visiting models on PPD and to identify core components predictive of the effectiveness of home visiting
programs in reducing PPD.
To determine the overall effectiveness of addressing PPD via home visiting, the research team will
systematically search, select, and review existing empirical studies, evaluate them for rigor and potential bias,
and quantitatively synthesize the effect sizes. To identify core components predictive of effective home visiting
programs, associations between intervention effect and study-level characteristics will be analyzed with meta-
regression analysis. Study-level characteristics—the potential core components— include the priority given to
PPD intervention by a home visiting program, types of home visitors, the duration and intensity of a home
visiting program, percentage of BIPOC participants in a home visiting program, and baseline level of and risk
for depression among service recipients.
