Screening for Postpartum Depression Among Low-Income Mothers Using an Interactive Voice Response System Helen G. Kim • Joni Geppert • Tu Quan • Yiscah Bracha • Virginia Lupo • Diana B. Cutts Published online: 17 May 2011 Ó Springer Science+Business Media, LLC 2011 Abstract This study tested the feasibility of using an interactive voice response (IVR) phone system to screen for postpartum depression among low-income, English- and Spanish-speaking mothers. Newly delivered mothers were interviewed in the hospital. Consenting subjects completed a background questionnaire and were asked to call an auto- mated phone system 7 days postpartum to complete an IVR version of the Edinburgh Postnatal Depression Screen (EPDS). During the phone screen, subjects were branched to different closing narratives based on their depression scores which were later posted to a password protected website. Logistic regression was used to assess relationships between demographic and psychosocial factors, IVR participation, and depression scores. Among 838 ethnically diverse, low income, postpartum mothers, 324 (39%) called into the automated phone screening system. Those who called were more likely to have at least a high school education (OR = 1.63, 95%CI: 1.23, 2.16), be employed (OR = 1.48, 95%CI: 1.08, 2.03) and have food secure households (OR = 1.50, 95%CI: 1.06, 2.13). There was no statistically significant difference between callers and non-callers in terms of marital status, race/ethnicity, parity, or self-reported history of depression. Postpartum depression symptoms were present in 17% (n = 55) and were associated with being single (AOR = 2.41, 95% CI: 1.29, 4.50), first time mother status (AOR = 2.43, 95% CI: 1.34, 4.40), temporary housing (AOR = 2.35, 95% CI: 1.30, 4.26), history of anxiety (AOR = 2.79, 95% CI: 1.69, 6.67), and history of self-harm (AOR = 2.66, 95% C: 1.01, 6.99). Automated phone screening for postpartum depression is feasible among disadvantaged mothers but those with the highest psychosocial risk factors may not choose or be able to access it. IVR could be used to supplement office- and home visit- based screening protocols and to educate patients about mental health resources. Keywords Postpartum depression Á Interactive voice response Á Mental health screening Á Underserved women Introduction Postpartum depression affects 7–25% of all women during the first year after delivery and is particularly common in low income and minority populations [1–3]. Postpartum depres- sion leads to maternal disability, impaired mother–child attachment, and infant social and cognitive developmental problems [4, 5]. Low income and minority women are at particularly high risk for unrecognized and untreated post- partum depression [6, 7]. This higher prevalence of postpartum depression among disadvantaged populations leads to health disparities in children of affected mothers [8]. Treatment of postpartum depression thus represents an urgent public health issue, particularly among disadvantaged populations [9]. H. G. Kim (&) Department of Psychiatry, Hennepin Women’s Mental Health Program, Hennepin County Medical Center, Minneapolis, MN 55404, USA e-mail: hkim@mnwomensprogram.org J. Geppert Á T. Quan Á D. B. Cutts Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN, USA Y. Bracha Center for Urban Health, Hennepin County Medical Center, Minneapolis, MN, USA V. Lupo Department of Obstetrics/Gynecology, Hennepin County Medical Center, Minneapolis, MN, USA 123 Matern Child Health J (2012) 16:921–928 DOI 10.1007/s10995-011-0817-6