Warren Alpert Medical School of Brown University
Presentation Abstracts
Identifying and Addressing Postpartum Mental Health Concerns
The collaborative care model (CCM) is a health services intervention that improves depression care in primary care settings. Over 80 randomized trials and several meta-analyses have demonstrated the effectiveness of the CCM for improving both depression and somatic health outcomes. While two randomized clinical trials have demonstrated improved perinatal depression outcomes with the CCM during obstetric care, the perinatal CCM is not broadly utilized. A major reason for this gap from evidence to practice is the substantive difference between obstetric and primary care at the patient, provider and system-level that may prevent direct adoption of the CCM to the perinatal context.
Two major gaps in knowledge prevent translation into routine clinical practice. First, the effectiveness of the perinatal CCM on outcomes of foundational importance to obstetric clinicians (e.g., somatic obstetric, neonatal, and healthcare utilization outcomes) remains unknown. Second, optimal implementation strategies for the CCM in the unique perinatal context are not established.
This presentation will discuss the state of the science pertaining to the perinatal CCM and suggest opportunities for future directions of research on evidence-based health services interventions such as the perinatal CCM.
Behavioral Health Concerns Impacting Postpartum Health
Behavioral health is an essential domain of wellness that holds significant impact on postpartum health. Gaps in this domain are leading contributors to maternal mortality and offer opportunities to refine approaches to postpartum care. This workshop convenes experts who will discuss the impact of mental health, addiction, and gender-based violence on postpartum health with particular attention to social, structural, and policy factors, structural inequities, and bioethics. Research gaps including lack of experimental evidence on clinical and policy interventions and future directions will be identified.
About Dr. Miller
Dr. Emily Miller is an Associate Professor at the Warren Alpert Medical School of Brown University and is the Division Director of Maternal Fetal Medicine at Women & Infants Hospital of Rhode Island. She received her M.D. from the New York University School of Medicine and her M.P.H. with a concentration in effectiveness outcomes research from the Columbia University Mailman School of Public Health. She completed residency training in obstetrics and gynecology as well as a fellowship in maternal fetal medicine at Northwestern University.
Dr. Miller has an expertise in obstetric and perinatal outcomes related to mental health conditions and has dedicated her career to optimizing the treatment of perinatal mental health. Her research innovates and evaluates health services to improve perinatal mental health care, with a focus on dissemination and implementation of the collaborative care model. She is currently supported by the National Institute of Mental Health to evaluate the use of technology to support the perinatal collaborative care model (subproject R34 PI, P50MH119029) and to evaluate the efficacy of the ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) intervention to prevent perinatal depression in birthing people with adverse childhood experiences (PI, R34MH130969). She is also the Principal Investigator (PI) for a Eunice Kennedy Shriver National Institute of Child Health and Human Development-funded study (R01HD105499) to evaluate a digital health intervention build from the collaborative care model designed to support the mental health of new parents.
Dr. Miller disclosed the following conflict of interest: Site PI for the Pfizer COVID-19 vaccine in pregnant people. (Site participation ended in March 2022.)