Inventory of Evidence-Based Practices (EBPs) for Healthy Start Programs

Evidence-based practices include actions, activities, strategies, or approaches that improve the health of women, before, during, and after pregnancy in order to improve birth outcomes and give infants up to age two years a healthy start. Also included in the collection are informational materials and tools that make it easier to implement evidence-based practices. To search by title, use the main search box located at the top of this page.

Most Recently Added EBPs:

Number of results: 24


ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns)

ROSE is a class taught in prenatal clinics that gives pregnant women the skills and information that they need to lower their risk of postpartum depression.Through four 90-minute sessions, the program teaches pregnant women to recognize the signs of depression and how to reduce stress by seeking social support, finding a network of friends and family members, and knowing where to go for help. The ROSES Study (ROSE Sustainment Study) is currently partnering with 90 clinics providing prenatal services to low-income women in all 50 states. The ROSES study will help determine what outside supports are needed to help prenatal clinics implement and sustain ROSE, reducing negative consequences for mother and child.

Topics:

Depression Mental Health Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Mothers and Babies

Mothers and Babies (MB) is a program that promotes healthy mood management by teaching pregnant women and new moms how to effectively respond to stress in their lives through increasing the frequency of thoughts and behaviors that lead to positive mood states. Designed as a perinatal depression prevention, the Mothers and Babies targets three specific risk factors: limited social support, lack of pleasant activities, and harmful thought patterns. Mothers and Babies offers a “toolkit” of approaches for women to observe their mood, note factors affecting their mood, and make changes in their daily lives to impact these areas. Based on principles of cognitive-behavioral therapy (CBT), attachment theory, and psychoeducation, the Mothers and Babies Course is designed to be delivered by clinic- or community-based providers from a variety of educational and professional backgrounds, and can be delivered as a group intervention or as a one-on-one intervention in various settings where pregnant women access services (e.g. prenatal clinics, home visiting programs, WIC programs, County Health Departments, etc.).

Topics:

Depression Home Visiting Maternal Morbidity and Mortality Mental Health Parenting Education Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

MotherWoman

MotherWoman promotes the resilience and empowerment of mothers and their communities by building community capacity and advocating for just policies through evidence based research and grassroots organizing. MotherWoman hosts support groups for postpartum women (in MA, CA and NY), provides training for healthcare and social service providers, supports communities in creating coalitions to address the issue of perinatal emotional complications and perinatal mood disorders on the community level, and works to raise awareness about social and economic justice issues and promote policies that positively impact mothers, children and families on the regional and national levels. The MotherWoman Support Group Model is replicable and has been successful with a broad diversity of postpartum mothers in a wide variety of settings. MotherWoman’s commitment to diversity and inclusion allows for diverse mothers to find common ground, inspiration and community with each other.

Topics:

Depression Health Equity Mental Health

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

ACOG Postpartum Toolkit

Often referred to as “The Fourth Trimester,” the weeks after birth are a critical time for a woman and her infant, setting the stage for long-term health and well-being. This comprehensive toolkit, with an introduction by Dr. Haywood Brown, includes extensive resources on the key components of postpartum care, including support for new mothers, reproductive life planning, infant care, counseling for substance use, long-term weight management, and many more pertinent topics. It also features a sample postpartum checklist for women to complete.

Topics:

Alcohol/Drug Services Breastfeeding Chronic Disease Depression Healthy Weight Immunization Intimate Partner Violence Reproductive Life Planning/Family Planning Safe Sleep Tobacco Cessation

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Initiating Breastfeeding Intimate Partner Violence Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit Reproductive Life Plan Safe Sleep Smoking Abstinence Sustaining Breastfeeding

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Committee Opinion on Optimizing Postpartum Care

Because one half of all pregnancy-related maternal deaths occur postpartum, the weeks following childbirth are a critical period for a woman and her infant. In addition, health issues that arise in pregnancy can persist and presage long-term medical problems. In this Committee Opinion, ACOG lays out a new vision for postpartum care, redefining it as an ongoing process beginning within the first 3 weeks postpartum and tailored to a woman’s needs. The document includes practical advice on postpartum care as well as useful charts including a Timeline for Postpartum Care, a listing of The Components of Postpartum Care, and a table identifying Members of the Postpartum Care Team.

Topics:

Breastfeeding Chronic Disease Depression Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Birth Spacing Initiating Breastfeeding Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit Reproductive Life Plan Sustaining Breastfeeding Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Rural Behavioral Health: Telehealth Challenges and Opportunities

This brief looks at common acceptability, availability, and accessibility barriers to mental and substance use disorder (behavioral health) treatment and services in rural communities and presents ways telehealth can help surmount some of these barriers. The term telehealth refers to using internet and communications technologies, such as videoconferencing, chat, and text messaging, to provide health information and treatments in real time.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Safe Homes, Safe Babies: Perinatal Safety Card

Safe Homes, Safe Babies is a safety card for women that perinatal health care providers can distribute to patients. In addition to providing safety resources for women, this tool also functions as a prompt for perinatal health care providers by providing quick phrases to improve discussions with women about the impact of domestic violence on their parenting and children. The safety card outlines questions women may ask themselves about their relationships, birth control use and parenting, while offering supportive messages and referrals to national support services for help.

Topics:

Depression Intimate Partner Violence Risk Assessment

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Thinking Healthy: A manual for psychosocial management of perinatal depression

This manual is designed for training community health workers on how to support expecting and new mothers with depression, using evidence-based cognitive behavioral techniques. Community Health Workers can assist depressed mothers to change their unhealthy patterns of thinking and behavior, leading to an improvement in their mood and functioning, and prevention of later problems in their infants. The manual provides a step-by-step guide for CHWs implementing the Thinking Healthy intervention in 15 sessions with mothers (from pregnancy through baby’s first 10 months), and includes a structured process for each session, activities, worksheets and charts, and communication tips. This manual is a generic version for global use of a manual originally developed in Pakistan and later used in many other countries.

Topics:

Depression Parenting Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Family Spirit

Family Spirit is an evidence-based early childhood home-visiting program designed for and by American Indian communities. Family Spirit combines the use of paraprofessionals from the community as home visitors and a culturally focused, strengths-based curriculum as a core strategy to support young families. From pregnancy through the child’s 3rd birthday, parents gain knowledge and skills to promote healthy development and positive lifestyles for themselves and their children. Family Spirit addresses intergenerational behavioral health problems, optimizes local cultural assets, and overcomes deficits in the professional health care workforce in low resource communities. Evidence from three randomized controlled trials has documented important results including: increased parenting knowledge and involvement; decreased maternal depression; increased home safety; decreased emotional and behavioral problems of mothers; and decreased emotional and behavioral problems of children. The Family Spirit curriculum modules cover: Prenatal Care, Infant Care, Your Growing Child, Toddler Care, My Family and Me, and Healthy Living.

Topics:

Alcohol/Drug Services Breastfeeding Depression Home Visiting Parenting Education Partner Involvement Prenatal Care and Education Reproductive Life Planning/Family Planning Socio-emotional Development for Children

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Father/Partner Prenatal Involvement Initiating Breastfeeding Perinatal Depression Follow Up Perinatal Depression Screening Reproductive Life Plan Safe Sleep Smoking Abstinence Sustaining Breastfeeding

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Mental Health First Aid

Mental Health First Aid is an 8-hour course that gives people the skills to help someone who is developing a mental health problem or experiencing a mental health crisis. The evidence behind the program demonstrates that it does build mental health literacy, helping the public identify, understand, and respond to signs of mental illness. Mental Health First Aiders learn a 5-step action plan that guides them through the process of reaching out and offering appropriate support. The “adult course” is available in both English and Spanish, and covers anxiety, depression, psychosis, and addictions in adults. The “youth course” is for adults who interact regularly with young people ages 12-18.

Topics:

Alcohol/Drug Services Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Moms’ Mental Health Matters

This new initiative is designed to educate consumers and health care providers about perinatal mood disorders, emphasizing the newly-appreciated fact that they include both depression and anxiety and can occur both during and after pregnancy. In addition to education, the site provides action plans, referrals, and advice for partners, family, and friends of affected women. Related materials including posters, tear sheets, and postcards, all in both English and Spanish, can be downloaded or ordered for free.

Topics:

Depression Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

4Ps Plus©

4Ps Plus© is the first validated instrument that has been developed to screen for alcohol, tobacco, and illicit drug use; depression; and domestic violence, specifically in pregnant women. In addition, brief intervention strategies, grounded in motivational interviewing techniques, are integrated into the screening process. “I am concerned…” is an interactive, multisensory psychoeducational approach that takes about five minutes and is administered to all women who are found through the screening process to be using alcohol, tobacco, or illicit drugs.

Topics:

Alcohol/Drug Services Depression Intimate Partner Violence Prenatal Care and Education Risk Assessment Tobacco Cessation

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Perinatal Depression Screening Smoking Abstinence

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Survey of Wellbeing of Young Children (SWYC)

The SWYC is a free comprehensive screening tool that assesses child development, behavior, and family risk. One double-sided form containing multiple choice questions written at a 6th grade level takes only about ten minutes to complete. Age-specific forms have been developed for each age in the pediatric periodicity schedule from 2-60 months. Surveys are available in 5 languages, and all questions are designed to be sensitive to cultural differences. In studies performed thus far, the accuracy of this tool appears to be comparable to longer screening instruments.

Topics:

Socio-emotional Development for Children

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Perinatal Depression Screening

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Healthy Families America

Designed for parents facing challenges including single parenthood, low income, and history of domestic violence, substance abuse, or mental health issues. Families are enrolled prenatally or at birth, and services are provided until the child’s 3rd or 5th birthday. Includes 1 home visit a week for the first 6 months, and less frequent visits after the child is 6 months of age.

Topics:

Case Management/Care Coordination Home Visiting Parenting Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Perinatal Depression Screening

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Postpartum Depression Screening Scale (PDSS)

The PDSS is a 35-item self-report instrument that can be administered in 5-10 minutes. Identifies women who are at high risk for postpartum depression so that they can be referred for definitive diagnosis and treatment. Written at a third grade reading level.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Edinburgh Postnatal Depression Scale (EPDS)

The Edinburgh Postnatal Depression Scale was developed to screen postpartum women for depression in an outpatient setting. It is a 10 question screen that takes about 3-5 minutes to complete, and is easy to score. The EPDS asks the patient how she has been feeling over the last seven days. It has been validated for use during both pregnancy and the post-partum period. It has been translated into 23 languages.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Depression During and After Pregnancy: A Resource for Women, Their Families, and Friends

Informational booklet for new mothers suffering from postpartum depression, published online in English and Spanish by the HRSA Maternal and Child Health Bureau.

For the Spanish version please click Here.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Prenatal Plus Program

Prenatal Plus is a program that provides care coordination, nutrition and mental health counseling to Medicaid-eligible pregnant women in Colorado who are at a high risk for delivering low birth weight infants. The program uses the client-centered counseling approach with all participants to address a variety of issues that have been shown to have a negative impact on birth outcomes. The key health areas targeted by this program are healthy weight, smoking cessation and depression. The program has been demonstrated to decrease the rate of low-birth weight infants and resolve the risks putting women at risk of delivering low-birth weight infants.

Topics:

Case Management/Care Coordination Depression Healthy Weight Tobacco Cessation

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Prenatal Involvement Perinatal Depression Follow Up Perinatal Depression Screening

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Patient Health Questionnaire-9 (PHQ-9)

Nine item questionnaire for patients to measure depressive symptoms over the past two weeks. Questions are linked to the DSM-IV depression criteria, and therefore scores can be used to track changes in depression as a response to treatment. Included on the Healthy Start National Evaluation Program Survey

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Center for Epidemiologic Studies Depression Scale Revised CESD-R

The CESD-R is a screening test for depression and depressive disorder. The CESD-R measures symptoms defined by the American Psychiatric Association’ Diagnostic and Statistical Manual (DSM-V) for a major depressive episode. The scale is well known and remains as one of the most widely used instruments in the field.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

BDI-FastScreen

The BDI-FastScreen is a 7-item self-reporting instrument used to quickly screen for depression in adolescents and adults. The screen can identify depression while excluding symptoms that might be related to medical problems, and was specifically designed for evaluating depression in patients whose behavioral and somatic symptoms attributable to biological, medical, alcohol and/or substance abuse problems may confound diagnosis.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.