Perinatal e-screening and clinical decision support: the Maternity Case-finding Help Assessment Tool (MatCHAT)
Tanya Wright 1 3 , Kate Young 2 , Margot Darragh 2 , Arden Corter 2 , Ian Soosay 1 , Felicity Goodyear-Smith 21 Counties Manukau District Health Board, Auckland, New Zealand, and Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
2 Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
3 Corresponding author. Email: t.wright@auckland.ac.nz
Journal of Primary Health Care 12(3) 265-271 https://doi.org/10.1071/HC20029
Published: 29 September 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Screening tools assist primary care clinicians to identify mental health, addiction and family violence problems. Electronic tools have many advantages, but there are none yet available in the perinatal context.
AIM: To assess the acceptability and feasibility of the Maternity Case-finding Help Assessment Tool (MatCHAT), a tool designed to provide e-screening and clinical decision support for depression, anxiety, cigarette smoking, use of alcohol or illicit substances, and family violence among pre- and post-partum women under the care of midwives.
METHODS: A co-design approach and an extensive consultation process was used to tailor a pre-existing electronic case-finding help assessment tool (eCHAT) to a maternity context. Quantitative MatCHAT data and qualitative data from interviews with midwives were analysed following implementation.
RESULTS: Five midwives participated in the study. They reported that MatCHAT was useful and acceptable and among the 20 mothers screened, eight reported substance use, one depression and five anxiety. Interviews highlighted extensive contextual barriers of importance to the implementation of maternity-specific screening.
DISCUSSION: MatCHAT has potential to optimise e-screening and decision support in maternity settings, but in this study, use was impeded by multiple contextual barriers. The information from this study is relevant to policymakers and future researchers when considering how to improve early identification of common mental health, substance use and family violence problems.
KEYwords: e-screening; perinatal; mental health; substance use; family; violence; midwifery
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