Postpartum Depression (PPD) has gained well-deserved traction in healthcare policy discourse as a public health concern. Although one in seven American women are believed to experience PPD, mental illness stigma induces feelings of shame and guilt, reduces treatment-seeking behaviors, and ultimately contributes to a low PPD diagnosis rate. Risk of experiencing PPD is associated with various contextual factors, yet little is known about the association between stigma and PPD risk factors. A multiple-segment factorial vignette was used with 1,871 respondents to examine the impact of maternal age, depression history, infant temperament, and diagnosis on attitudes toward PPD. In addition, the impact of an educational video on PPD symptom recognition and stigmatizing attitudes was examined with a subsample of 1,178 respondents. Results demonstrated that a mother’s age, history of depression, and her infant’s temperament impacted respondents’ attribution of her symptoms to baby blues or PPD, and also influenced stigmatizing attitudes toward her PPD experience. Results also revealed that the educational video had a positive effect on symptom recognition and reduced stigmatizing views. Implications of these findings are discussed.

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Introduction: Breastfeeding has numerous benefits for babies, mothers, and families. It is well established that mothers perceptions of embarrassment, convenience, and social support related to breastfeeding affect whether they choose to breastfeed and for how long . Tennessee falls well below national statistics and goals for breastfeeding initiation and continuation. Effective and efficient promotional tools that can be incorporated into clinical care are needed. Objectives: This study evaluated the effectiveness of a video intervention to improve perceptions of breastfeeding among pregnant women presenting for a prenatal visit in an obstetrics and gynecology (OB/GYN) clinic in northeast Tennessee. Specifically, the project sought to determine whether watching the video with the babys father, a friend, or family member (supportive others) would be more beneficial than watching it alone, a previously unanswered question. Methods: The investigative team established a relationship with an OB/GYN clinic that serves a high volume of pregnant women. A 15 minute video addressing issues of embarrassment, convenience and support related to breastfeeding was shown in the clinic waiting room. The video had been previously developed and evaluated by the Mississippi Department of Health. Pregnant women visiting the clinic during 8 days in 2009 were invited to complete an anonymous written survey immediately before and after viewing the video. The survey included items on demographics, perceptions of breastfeeding, and intention to breastfeed. Descriptive statistics were calculated. The proportion of women reporting improved perceptions of breastfeeding was compared between subgroups using chi-square testing. Mean breastfeeding perception scores were compared between subgroups and changes in womens intention to breastfeed were evaluated. Results: Of the 77 participants, 38.9% reported previously breastfeeding a child, 51.3% planned to breastfeed, and 25% were undecided. After viewing the video, perceptions of embarrassment, convenience, and social support related to breastfeeding improved in a range of 39-44.2%, 37-40%, 39-63% of women, respectively. Mothers who watched the video with a supportive other were more likely to report improved perceptions of embarrassment than mothers who watched the video alone (chi2 = 12.01, p = .002). Of the mothers who reported being undecided about breastfeeding prior to watching the video, 57.9% reported being more likely to breastfeed after watching the video (chi2=10.22, df=2, p=0.006). Discussion: The findings suggest this video intervention is an effective means of addressing barriers to breastfeeding in the clinical setting. Furthermore, this study addressed previously unanswered questions about the impact of pregnant mothers watching the video with supportive others; results indicate that its efficacy is significantly improved if pregnant women view it with a supportive other.

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Early detection facilitates early intervention (EI), which optimizes outcomes in autism spectrum disorders (ASD) and other developmental delays. However, facilitating the transition between receiving a diagnosis of ASD and other delays and accessing care has received little attention. When families first receive a diagnosis, they often experience grief, confusion, heightened stress, and difficulty accessing appropriate and affordable services, further increasing the disadvantages and disparity experienced by underrepresented populations. This feasibility study will focus on ways providers can better facilitate access to EI services for families following an initial diagnosis. Forty-nine diverse parents with children (16-32 m) diagnosed with ASD and other developmental delays were recruited from a larger screening study. During feedback, all families were provided with a provider list (treatment as usual) of therapeutic services. Half of the families were randomly assigned to receive a DVD/ Youtube Link (treatment plus video) that describes the diagnosis as well as common therapeutic options for children with developmental delays. Parents were asked questions regarding their use of materials (video vs. provider list) following feedback and their ability to access EI services. Study retention, demand and satisfaction were assessed to evaluate the use of video recommendations and the provider list. Demand, satisfaction and completion rates were assessed to evaluate the use of video recommendations as a feasible intervention following diagnosis. Additionally, differences in post measures of parental sense of competence, parental stress and access to the EI system were used to assess the potential efficacy of the intervention. Seventy- five percent of parents (across both treatment groups) used the provider list, whereas only 29% of parents who were randomized to the video condition reported that they viewed the video recommendations. Qualitative reactions from parents in the current investigation suggest a need for interdisciplinary care and coordination between mothers. Challenges to delivering a brief intervention following diagnosis are explored.