Validity and Acceptability of Kimberley Mum's Mood Scale to Screen for Perinatal Anxiety and Depression in Remote Aboriginal Health Care Settings

The Edinburgh Postnatal Depression Scale (EPDS) is widely recommended for perinatal anxiety and depression screening. However, many Aboriginal women find EPDS language complex and confusing, and providers find using it with Aboriginal women challenging. The two part Kimberley Mum's Mood Scale (...

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Bibliographic Details
Published in:	PloS one Vol. 12; no. 1; p. e0168969
Main Authors:	Marley, Julia V, Kotz, Jayne, Engelke, Catherine, Williams, Melissa, Stephen, Donna, Coutinho, Sudha, Trust, Stephanie K
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 30-01-2017 Public Library of Science (PLoS)
Subjects:	Aboriginal Australians Acceptability Adolescent Adult Affect Anxiety Anxiety - diagnosis Biology and Life Sciences Childrens health Cognitive ability Delivery of Health Care Demographic aspects Depression, Postpartum - diagnosis Diagnosis Diagnostic systems Emotions Evaluation Female General Practitioners Health aspects Health care Humans Mass Screening Maternal & child health Medical research Medical screening Medicine and Health Sciences Mental depression Mental disorders Mental health care Mood Native peoples Native women Oceanic Ancestry Group Patient Acceptance of Health Care Postpartum depression Pregnancy Psychiatric Status Rating Scales Psychological aspects Reference Standards Reproducibility of Results Research and Analysis Methods Risk Risk Factors Social Sciences Systematic review Test validity Western Australia Women's health Womens health Young Adult Australia
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Summary:	The Edinburgh Postnatal Depression Scale (EPDS) is widely recommended for perinatal anxiety and depression screening. However, many Aboriginal women find EPDS language complex and confusing, and providers find using it with Aboriginal women challenging. The two part Kimberley Mum's Mood Scale (KMMS) was developed to improve screening: Part 1 is a Kimberley version of EPDS; Part 2 is a psychosocial tool that enables contextualisation of Part 1 scores. We aimed to determine if KMMS is a valid and acceptable method of identifying Kimberley Aboriginal perinatal women at risk of anxiety or depressive disorders compared to a semi-structured clinical interview. Across 15 sites in the Kimberley, Western Australia, 97 Aboriginal women aged 16 years and older who intended to continue with their pregnancy or had a baby within the previous 12 months were administered the KMMS by trained healthcare providers who provided an overall assessment of no, low, moderate or high risk; 91 participants were then independently assessed by a blinded clinical expert using Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. A qualitative approach was used to determine KMMS' acceptability. Part 1 had high internal consistency (Cronbach's alpha, 0.89), and overall KMMS risk equivalence for screening for anxiety or depressive disorders was moderate (sensitivity, 83%; specificity, 87%; positive predictive value, 68%). Participants found the process easy and useful, and healthcare providers found KMMS more useful than EPDS. Part 2 allowed healthcare providers to ask questions that gave participants an opportunity to express themselves, resulting in a deeper understanding between them. KMMS is an effective tool for identifying Kimberley Aboriginal perinatal women at risk of anxiety and depressive disorders. Adoption of KMMS with culturally safe training and support is likely to improve screening processes, and with further validation may have broader applicability across remote Australia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceptualization: JK JM CE MW SC ST.Data curation: JM JK CE MW DS.Formal analysis: JM CE ST JK DS MW SC.Funding acquisition: JK SC JM MW DS CE ST.Investigation: JK CE MW DS.Methodology: JM JK CE MW.Project administration: JK MW.Resources: JK SC CE MW.Supervision: JM JK CE MW ST.Validation: CE.Visualization: JM.Writing – original draft: JM.Writing – review & editing: JM JK CE MW DS SC ST.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0168969