Training health visitors to reduce levels of depression after childbirth: An evaluation

Abstract

Postnatal depression has become a popular topic for intervention research. However, few studies have assessed implementation in the real world of primary care practice. This paper uses an AB design to assess health visitor training in the management of postnatal depression, replicated in eleven sectors in Stoke-on-Trent and Lewisham. Nearly 90% of health visitors volunteered for training. Only 64 of the 151 participating health visitors completed both pre and post training questionnaires but these did demonstrate highly significant improvement in self-ratings of knowledge and skills. Future studies should undertake direct assessments of all health visitors' practice. More important, however, is the significant reduction in levels of depressive symptomatology among their patients as rated on the Edinburgh Postnatal Depression Scale (EPDS). Six month postnatal EPDS scores were reduced in ten of the eleven sectors, nine significantly. Improvements to the research design are proposed to increase confidence in the effectiveness of training.