Transcript The Hawthorne Effect and Maternal Depression Screenings

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
[email protected]
Background
A brief overview
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4 – 16 % of women experience depression during
pregnancy
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Discontinued use of antidepressants when
pregnant, increased rate of recurrence
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Difficult detection due to overlapping pregnancy
symptoms
Major Depressive Disorder
 Observational phenomenon
 Highly debated amongst scholars
 Shown to alter patient and physician
behaviors
Hawthorne Effect
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
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Mixed methods observational study
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Assess how social and institutional factors affect
detection and treatment of maternal MDD
Pace (Pregnancy and Changing Emotions) Study
Start of PACE Study
End of PACE Study
Jan 2010 – March 2010
Jan 2009- March 2009
July 2009
Baseline maternal
MDD rate
May 2013
Comparison maternal
MDD depression rate
Timeline of PACE Study
Project Goals

Determine whether or not Hawthorne Effect alters
the detection and treatment of MDD in POGA
practice
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Quantify the Hawthorne Effect
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Create baseline rate of depression detection
before the PACE study
Goals
Initial Work

Learn the methodology of health services research
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Obtaining Data
◦ Literature search
◦ Article analysis
◦ Understand bigger picture
◦ Delivery Log abstraction
◦ Construct chart abstraction form
◦ Electronic medical record training
◦ Depression detection rate spreadsheet
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Writing projects
◦ Introduction to Hawthorne paper
◦ Methods section of Hawthorne paper
Initial work
Methods
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Abstract 3 month period of deliveries from POGA
delivery logs
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Use EPIC EMR medical records to view patient
files
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Document depression diagnoses with chart
abstraction form
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Obtain rate of depression detection and treatment
through spreadsheet
Methods

Completing documentation via EPIC medical
records
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Quantifying rate of depression detection
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Determining whether or not there is a Hawthorne
Effect
Work in Progress
Reflections
A look back
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Jim Coyne, PhD
Ian Bennett, MD, PhD
Steve Marcus, PhD
Jessica Rinaldi
Laura Hanisch, PhD
Steve Palmer, PhD
Special Thanks
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Halbreich U. Prevalence of mood symptoms and depressions during pregnancy:
implications for clinical practice and research. CNS Spectr. 2004;9(3):177-184
Kupfer DJ, Frank E, Perel JM, et al. Five-year outcome for maintenance therapies in
recurrent depression. Arch Gen Psychiatry. 1992;49(10):769-773
Anita H. Clayton, MD. Considerations in Women’s Mental Health: Depression During
Pregnancy. Primary Psychiatry. 2004;11(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 2002;37,6: 1603–1623.
References