1. COMMUNITY AWARENESS PROGRAMS

Transcription

1 . COMMUNITY AWARENESS PROGRAMS.. METHOD... Research questions This section of the report covers clinical question 2, which relates the effectiveness of community awareness programs at increasing help seeking behaviour (shown in Table.). The following mental health disorders were selected for inclusion in this systematic literature view: depression, anxiety, puerperal psychosis and bipolar disorder. In the context of this review, the term perinatal depression and related disorders refers to these four conditions only. Table. Clinical questions included in this section of the report ID Q2 Clinical question Q2a: How effective are community awareness programs that aim to prevent depression at increasing the number of women or their partners/carers who seek help in the perinatal period? Q2b: As above, but for anxiety Q2c: As above, but for puerperal psychosis Q2d: As above, but for bipolar disorder..2. Criteria for determining study eligibility The criteria for determining if publications were eligible for inclusion in the community awareness program section of the systematic literature review are shown in Table.2. Studies were eligible for inclusion if they represented NHMRC Evidence Level IV or higher using the intervention scale. This restricted the study type to publications with a comparison arm. Studies were eligible for inclusion if they were aimed at the general population and aimed to increase community awareness of perinatal depression or a related disorder. The publications were not restricted by comparator. The outcomes extracted were the proportion of women or carers who sought help. Table.2 Criteria for determining study eligibility: Community awareness programs Study design NHMRC Evidence Level IV or higher (using the intervention scale a ) Population Pregnant women and women up to year postnatally or their carers Intervention A community awareness program for a mental health disorder Comparator Any Outcomes Proportion of women or their carers who seek help Abbreviations: NHMRC=National Health and Medical Research Council a NHMRC Intervention scale: Level I: A systematic review of level II studies, Level II: A randomised controlled trial, Level III-: A pseudo randomised controlled trial, Level III-2: A comparative study with concurrent controls, Level III-3: A comparative study without concurrent controls, Level IV: Case series with either post-test or pre-test/post-test outcomes..3. Literature search methodology A systematic method of literature searching and selection was employed in the preparation of this review. A search was conducted in EMBASE, Medline, PsycInfo, CINAHL and the Cochrane Database of Systematic Reviews. Searches were not restricted by date. Search terms were entered as keywords, exploded where possible, and as free text within the title and/or abstract, in the EMBASE and Medline databases. Variations on these terms were used for the Cochrane library, PsycInfo and CINAHL searches after modifications were made to suit the keywords and descriptors of each search platform.

2 The reference lists of included papers were reviewed to identify any peer-reviewed evidence that may have been missed in the literature search. Contacting of authors for unpublished research was not undertaken in this review. Conference abstracts were not eligible for inclusion. The searches were conducted between 3 June 29 and 27 July 29. Therefore, studies published after this time were not eligible for inclusion in the systematic review. The search strategy is shown in Table.3. A total of 693 non-duplicate citations were identified. Table.3 Search strategy for community awareness programs Database EMBASE + Medline PsycInfo Date searched <95 3 Jun Jul Week 3 29 # Search terms Citations pregnan* OR matern* OR antepart* OR postpart* OR prenat* OR antenatal* OR perinatal* OR peripart* OR postnatal* OR 'puerperal'/exp OR 'puerperal' 89,8 2 ('anxiety disorder'/exp OR 'anxiety disorder') OR ('mixed anxiety and depression'/exp OR 'mixed anxiety and depression') OR ('depression'/exp OR 'depression') OR ('atypical depression'/exp OR 'atypical depression') OR ('major depression'/exp OR 'major depression') OR ('bipolar disorder'/exp OR 'bipolar disorder') OR ('bipolar depression'/exp OR 'bipolar depression') OR ('bipolar mania'/exp OR 'bipolar mania') OR ('mixed mania and depression'/exp OR 'mixed 528,353 mania and depression') OR ('anxiety'/exp OR 'anxiety') OR ('psychosis'/exp OR 'psychosis') OR ('puerperal psychosis'/exp OR 'puerperal psychosis') OR ('manic depressive psychosis'/exp OR 'manic depressive psychosis') OR ('manic psychosis'/exp OR 'manic psychosis') AND [<95-29]/py 3 'help seeking behaviour'/exp OR 'help seeking behaviour' OR 'help seeking behavior'/exp OR 'help seeking behavior' OR 'patient referral'/exp OR 'patient referral' OR 'treatment seeking behaviour'/exp OR 'treatment seeking behaviour' OR 'treatment seeking behavior'/exp OR 'treatment seeking behavior' OR 'community program'/exp OR 'community program') OR 'community awareness' OR 'mental health promotion' OR 'campaigns' OR 'mental health campaigns' OR 'referral'/exp OR 'referral' 89,443 4 # AND #2 AND #3 353 exp Pregnancy/,837 2 pregnan$.mp. 23,357 3 matern$.mp. 3,854 4 antepart$.mp postpart$.mp. 5,779 6 prenat$.mp. 2,454 7 antenatal$.mp.,57 8 perinatal$.mp. 4,746 9 peripart$.mp. 4 postnatal$.mp. 9,872 puerperal.mp or/- 64,344 3 exp Anxiety Disorders/ 44,645 4 exp major depression/ 65,36 5 atypical depression/ 2 6 exp Bipolar Disorder/ 3,578 7 ((bipolar or bi polar) and (disorder$ or depress$)).ti. 6,239 8 ((bipolar or bi polar) and (disorder$ or depress$)).ab. 4,63 9 (mania or manic or hypomania).ti,ab. 3,56 2 exp Anxiety/ 38,677 2 (anxious or anxiety or panic).ti,ab. 6,4 22 exp psychosis/ 73,86 23 exp Postpartum Psychosis/ 7 24 (psychos$ or psychotic$).ti,ab., ((bipolar or bi polar) and (disorder$ or depress$)).id., (mania or manic or hypomania).id. 6, (anxious or anxiety or panic).id. 52, or/ , and 2,538

3 Database Date searched CINAHL Jul 29 # Search terms Citations 3 exp Help Seeking Behavior/ 4,57 3 help seeking behavior.mp. 3,38 32 help seeking behaviour.mp exp Professional Referral/ 2, patient referral.mp exp Health Care Seeking Behavior/,83 36 treatment seeking behavior.mp treatment seeking behaviour.mp exp Community Services/ 9,99 39 community program.mp community awareness.mp. 7 4 exp Mental Health Programs/ 7, exp Health Promotion/ 7,76 43 mental health promotion.mp campaigns.mp. 3, mental health campaigns.mp referral.mp., or 33 or 32 or 42 or 46 or 3 or 44 or 39 or 36 or 4 or 4 or 38 or 34 or 37 or 45 or 43 or 3 49, and S (MH "Pregnancy+") 63,998 S2 TX pregnan* 69,536 S3 TX matern* 3,59 S4 TX antepart* 649 S5 TX postpart* 6,58 S6 TX prenat* 5,753 S7 TX antenatal* 2,758 S8 TX perinatal* 2,979 S9 TX peripart* 24 S TX postnatal* 6,75 S TX puerperal 54 S2 S or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S or S 94,675 S3 (MH "Anxiety Disorders+") 9,5 S4 (MH "Depression+") 26,888 S5 (MH "Bipolar Disorder+") 2,484 S6 TI ( bipolar or bi polar ) and TI ( disorder* or depress* ),66 S7 AB ( bipolar or bi polar ) and AB ( disorder* or depress* ),8 S8 TI ( mania or manic or hypomania ) or AB ( mania or manic or hypomania ) 788 S9 (MH "Anxiety+") 9,348 S2 TI ( anxious or anxiety or panic ) or AB ( anxious or anxiety or panic ) 6,238 S2 (MH "Psychotic Disorders+") 32,85 S22 TI ( psychos* or psychotic* ) or AB ( psychos* or psychotic* ) 8,473 S23 S3 or S4 or S5 or S6 or S7 or S8 or S9 or S2 or S2 or S22 9,47 S24 S2 and S23 5,625 S25 (MH "Help Seeking Behavior"),498 S26 TX ( "help seeking behavior" OR "help seeking behaviour" ),578 S27 (MH "Referral and Consultation+"),76 S28 TX ( "patient referral" ) 98 S29 TX ( "treatment seeking behavior" OR "treatment seeking behaviour" ) 6 S3 (MH "Community Programs") 2,85 S3 TX ( "community program" ) 9 S32 TX ( "community awareness" ) 64 S33 (MH "Mental Health Promotion (Saba CCC)")

4 Database Cochrane Library Date searched 8 3 Jun 29 # Search terms Citations S34 TX ( "campaigns" ),792 S35 TX ( "mental health campaigns" ) S36 TX ( "referral" ) 7,299 S37 S25 or S26 or S27 or S28 or S29 or S3 or S3 or S32 or S33 or S34 or S35 or S36 23,834 S38 S24 and S37 7 'help seeking behaviour' OR 'help seeking behavior' OR 'patient referral' OR 'treatment seeking behaviour' OR 'treatment seeking behavior' OR 'community program' OR 'community awareness' OR 'mental health promotion' OR 'campaigns' OR 'mental health campaigns' OR 'referral' 2 'anxiety disorder' OR 'mixed anxiety and depression' OR 'depression' OR 'atypical depression' OR 'major depression' OR 'bipolar disorder' OR 'bipolar depression' OR 'bipolar mania OR 'mixed mania and depression' OR 'anxiety' OR 'psychosis' 34,42 OR 'puerperal psychosis' OR 'manic depressive psychosis' OR 'manic psychosis' 3 pregnan* OR matern* OR antepart* OR postpart* OR prenat* OR antenatal* OR perinatal* OR peripart* OR postnatal* OR 'puerperal' 24,893 4 # AND #2 AND #3 96 Manual search Total number of citations 88 Total number of non-duplicate citations 693 5, Assessment of study eligibility Publications identified in the literature search were reviewed and the exclusion criteria shown in Table.4 applied hierarchically. Publications were excluded if they were the wrong study type (eg non-systematic reviews, animal studies or letters), if they were in the wrong population (not aimed at the general population), or evaluated the wrong intervention (not a perinatal mental health community awareness program). Publications were excluded if they reported the wrong outcomes (not the proportion of women or their carers seeking help). Only English language publications were eligible for inclusion. Table.4 Exclusion criteria: Community awareness programs Wrong study type Wrong population Wrong intervention Wrong outcome Not in English Not a NHMRC Evidence Level IV or higher (using the intervention accuracy scale) Not aimed at the general population Does not evaluate a community awareness program for a mental health disorder Does not report the proportion of women or their carer seeking help Non-English publications will not be included A total of 693 citations were identified in the initial literature search (shown in Table.3). The exclusion criteria was applied to all citations by reviewing the abstract and title, with 692 publications excluded (shown in Table.2). A total of publication remained, and the full text version was retrieved and reviewed. This publication was excluded as it was the wrong study type. Therefore, no publications met the inclusion criteria for this clinical question. A full list of excluded citations annotated by the key reason for exclusion is shown in Appendix X.

5 Table.5 Assessment of study eligibility: Excluded and included citations for community awareness programs search Exclusion criteria Number Total citations 693 Citations excluded after review of abstract/title Wrong study type Wrong population Wrong intervention Wrong outcome Not in English Total excluded citations Full papers reviewed: Citations excluded after review of full publication Wrong study type Wrong population Wrong intervention Wrong outcome Not in English Total excluded citations Total included citations

6 COMMUNITY AWARENESS PROGRAMS (Q2): RESULTS.2. RESULTS AND DISCUSSION The systematic literature search did not identify any publications which met the eligibility criteria for this question. Summary In summary, there was no evidence relating to the effectiveness of community awareness programs for mental health disorders.