Table 1.

TTT training cycle

Workshop #1 (Month 1)

Educate trainers about perinatal depression: 4 lectures—Introduction to Perintal Mood Disorders, Negative Effects of Maternal Depression, Screening and Referral, Psychological and Medical Treatments Assign trainers to a mentor (perinatal depression experts) for one-to-one consultation

Trainer Assignments following Workshop #1 (Months 1–4)

Develop training slides Develop a screening and referral protocol for their agency Practice administering the Edinburgh Postnatal Depression Screening Scale (EPDS) to two women and record brief observationsa

Workshop #2 (Month 4)

Review trainers’ brief observations from practice EPDS administration Educate trainers about planning a training in their agencies: 1 lecture—Logistics of Planning a Training which included information on strategic setting of training dates, developing an agenda, advertising, obtaining a venue, ensuring adequate technical support and providing handouts Prepare trainers for staff resistance to implementing screening: 1 lecture—Resistance to Implementationb

Trainer Assignments following Workshop #2

Develop a brief summary sheet of the screening and referral protocol Develop a consent-to-contact primary care provider form Develop training slides to describe their agency’s screening protocol One-to-one phone consultation with the mentor, trainer, and agency supervisor to discuss questions or concerns about implementation of screening in their agency

Upon completion (variable timing 6–9 months)

Receive program completion certificates Train agency about perinatal depression and implement screening in their agency Collect 3 months of screening data

^aAll participating agencies were required to use the EPDS, a 10-item scale validated for use with perinatal women as well as a cutoff score of ≥12

^bRogers’ Diffusion of Innovations Theory was used as a lecture framework as this theory emphasizes two key y points: implementation of an innovation is not likely to be immediate and staff will vary in their willingness to adopt a new practice