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The Hawthorne Effect and Maternal Depression Care

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4 16 % of women experience depression during pregnancy ... PH Feil, JS Grauer, CC Gadbury-Amyot, K Kula, MD McCunniff, 'Intentional use of ... – PowerPoint PPT presentation

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Title: The Hawthorne Effect and Maternal Depression Care


1
The Hawthorne Effect and Maternal Depression Care
  • Research Advisors Jim Coyne, PhD
  • Ian Bennett, MD, PhD
  • Steve Marcus, PhD
  • John Paul Julien
  • University of Pennsylvania
  • jjulien89_at_gmail.com

2
Background
  • A brief overview

3
Major Depressive Disorder
  • 4 16 of women experience depression during
    pregnancy
  • Discontinued use of antidepressants when
    pregnant, increased rate of recurrence
  • Difficult detection due to overlapping pregnancy
    symptoms

4
Hawthorne Effect
  • Observational phenomenon
  • Highly debated amongst scholars
  • Shown to alter patient and physician behaviors

5
Pace (Pregnancy and Changing Emotions) Study
  • 5R01MH081916-02 grant (P.I. James Coyne)
  • Identify influences on access and barriers to
    care of major depressive disorder (MDD) for
    pregnant and postpartum women
  • Mixed methods observational study
  • Assess how social and institutional factors
    affect detection and treatment of maternal MDD

6
Timeline of PACE Study
Start of PACE Study
End of PACE Study
Jan 2009- March 2009
Jan 2010 March 2010
July 2009
May 2013
Baseline maternal MDD rate
Comparison maternal MDD depression rate
7
Project Goals
8
Goals
  • Determine whether or not Hawthorne Effect alters
    the detection and treatment of MDD in POGA
    practice
  • Quantify the Hawthorne Effect
  • Create baseline rate of depression detection
    before the PACE study

9
Initial Work
10
Initial work
  • Learn the methodology of health services research
  • Literature search
  • Article analysis
  • Understand bigger picture
  • Obtaining Data
  • Delivery Log abstraction
  • Construct chart abstraction form
  • Electronic medical record training
  • Depression detection rate spreadsheet
  • Writing projects
  • Introduction to Hawthorne paper
  • Methods section of Hawthorne paper

11
Methods
12
Methods
  • Abstract 3 month period of deliveries from POGA
    delivery logs
  • Use EPIC EMR medical records to view patient
    files
  • Document depression diagnoses with chart
    abstraction form
  • Obtain rate of depression detection and treatment
    through spreadsheet

13
Work in Progress
  • Completing documentation via EPIC medical records
  • Quantifying rate of depression detection
  • Determining whether or not there is a Hawthorne
    Effect

14
Reflections
  • A look back

15
Special Thanks
  • Jim Coyne, PhD
  • Ian Bennett, MD, PhD
  • Steve Marcus, PhD
  • Jessica Rinaldi
  • Laura Hanisch, PhD
  • Steve Palmer, PhD

16
References
  • Halbreich U. Prevalence of mood symptoms and
    depressions during pregnancy implications for
    clinical practice and research. CNS Spectr.
    20049(3)177-184
  • Kupfer DJ, Frank E, Perel JM, et al. Five-year
    outcome for maintenance therapies in recurrent
    depression. Arch Gen Psychiatry.
    199249(10)769-773
  • Anita H. Clayton, MD. Considerations in Womens
    Mental Health Depression During Pregnancy.
    Primary Psychiatry. 200411(7)17-18
  • Amici et al, Impact of the Hawthorne Effect in a
    Longitudinal Clinical Study The Case of
    Anesthesia, Controlled Clinical Trials 2000 21
    103-114.
  • Rob McCarney, James Warner, Steve Iliffe,
    Robbert van Haselen, Mark Griffin Peter Fisher,
    The Hawthorne Effect a randomised, controlled
    trial, BMC Medical Research Methodology 2007 7
    30
  • PH Feil, JS Grauer, CC Gadbury-Amyot, K Kula, MD
    McCunniff, Intentional use of the Hawthorne
    effect to improve oral hygiene compliance in
    orthodontic patients, Journal of Dental
    Education 2002 66 1129-1135.
  • Rita Mangione-Smith, Marc N Elliott, Laurie
    McDonald, Elizabeth A McGlynn, An Observational
    Study of Antibiotic Prescribing Behavior and the
    Hawthorne Effect, Health Services Research
    200237,6 16031623.
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