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NURS FPX 6026 Assessment 3 Letter to the Editor: Population Health Policy Advocacy EZ

Letter to the Editor: Population Health Policy Advocacy

NURS FPX 6026 Assessment 3 Letter to the Editor: Population Health Policy Advocacy 

I am writing in response to the “Negative Correlation Between Health Care Coverage and Postpartum Depression Among Hispanic Women” in the February 24, 2021, issue of the American Journal of Obstetrics and Gynecology. The risk of developing postpartum depression (PPD) is higher among Latinas, affecting 37% versus 10 to 15% of women of other ethnicities (Lara-Cinisomo et al., 2018). Latina women face many challenges because of their lower socioeconomic status, language barriers, and ethnic injustices. As a result, they are less likely to seek necessary treatment, mental health services, or report any concerns. In a study by Shellman et al. (2014) found that 60% of the Latina women experienced PPD, with 54% experiencing suicidal ideation. Early detection of PPD in Latina expectant mothers and community health worker (CHW) collaboration with obstetricians is crucial to decrease serious health consequences for mothers and infants. Women can experience bonding difficulties because of PPD which can lead to sleep disturbances, poor feeding, or cognitive defects for the infant.

NURS FPX 6026 Assessment 3 Letter to the Editor: Population Health Policy Advocacy 

Inter professional Team and Added Engagement

Adding a CHW to the inter professional team will improve the identification and treatment of PPD in Latina expectant mothers. CHWs share a common identity with members of their community such as culture, language, or socioeconomic status. The CHWs will be provided by a partnership between the obstetrician and local The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices. WIC staff already work closely with the mothers and their newborns in nutrition and often are bilingual. The provider or primary will refer the Latina mothers if the patient scores 8 or greater on the EPDS assessment. The CHWs will provide expectant mothers with needed services by collaborating with social workers, counselors, and lactation consultants. The CHW will meet with the expectant mothers to throughout their pregnancy to discuss social determinants of health needs. The CHW will work connect with the expectant mothers via home visits or telephonically to monitor their wellbeing. The benefits of continued outreach by the CHWs include establishing a trusting relationship that aids in connecting healthcare providers, psychosocial support, and assisting in coordinating resources (Lutenbacher et al., 2018).

Advocating For Policy Change

NURS FPX 6026 Assessment 3 Letter to the Editor: Population Health Policy Advocacy 

CHWs will interact directly with the at-risk Latina expectant mothers. CHWs will help improve depression screening and use of community resources. CHWs will educate the mothers on the PPD, the significance of early detection, and the effects of PPD on the newborn. Stigma, lack of recognition of symptoms or misconceptions about PPD among Latinas and their physicians can complicate early detection of depressive or anxiety symptoms (Sampson et al., 2021). They will educate with sensitivity to the Latino culture while also trying to decrease the stigma of PPD. With consideration to their main role at the WIC office, CHWs will also focus on the self-care, nutrition for the mother and child while also encouraging partner support. 

Studies from Lutenbacher et al. (2018) and Sampson et al. (2021) both support early intervention, culturally appropriate assessment, and community support for Latina mothers. Individual and cultural beliefs complicate the presentation and interpretation of depressive symptoms in Latina mothers it is imperative to connect them with a CHW who understands their struggles. CHWs will engage in meaningful discussions with the at-risk mothers offering counter narratives to the traditional patriarchal ideas of their culture to improve maternal mental health and wellbeing (Sampson et al., 2021).


Lara-Cinisomo, S., Zhu, K., Fei, K., Bu, Y., Weston, A. P., & Ravat, U. (2018). Traumatic events: Exploring associations with maternal depression, infant bonding, and oxytocin in latina mothers. BMC Women’s Health, 18(1), 31-31. https://doi.org/10.1186/s12905-018-0520-5

Lutenbacher, M., Elkins, T., Dietrich, M. S., & Riggs, A. (2018). The efficacy of using peer mentors to improve maternal and infant health outcomes in hispanic families: Findings from a randomized clinical trial. Maternal and Child Health Journal, 22(Suppl 1), 92-104. https://doi.org/10.1007/s10995-018-2532-z

Rajendran, S., Lutenbacher, M., & Dietrich, M. S. (2021). Negative Correlation Between Health Care Coverage and Postpartum Depression Among Hispanic Women. Hispanic Health Care International19(3), 182-189. https://doi.org/10.1177/1540415321993428 

Sampson, M., Yu, M., Mauldin, R., Mayorga, A., & Gonzalez, L. G. (2021). ‘You withhold what you are feeling so you can have a family’: Latinas’ perceptions on community values and postpartum depression. Family Medicine and Community Health, 9(3), e000504. https://doi.org/10.1136/fmch-2020-000504

Shellman, L., Beckstrand, R. L., Callister, L. C., Luthy, K. E., & Freeborn, D. (2014). Postpartum depression in immigrant Hispanic women: a comparative community sample. Journal of the American Association of Nurse Practitioners26(9), 488–497. https://doi.org/10.1002/2327-6924.12088

Letter to the Editors and Reply

Every Letter to the Editors and Reply must include a title page, conflict of interest disclosure, and a Statement of Authorship signed by all authors. These submissions are subject to minor editorial alterations, may be shortened without the authors’ approval, and are accepted for publication at the discretion of the Editors. Letters to the Editors are published both in print and on the Journal website. Selected Letters to the Editors that focus on at least 1 article published in the American Journal of Obstetrics and Gynecology within the previous 12 issues are considered for publication. Letters to the Editors are limited to 3 authors, 400 words (not counting the title page or references), and 1 to 4 references. At least one of the references must cite the related Journal article(s). All data presented must be fully citable and cited in the supporting reference list (unpublished data must not be described in the letter). The editors routinely invite the author(s) of the related article to respond in writing. Letters that include specific questions for the original article’s authors are prioritized for publication. Published letters are accompanied by either a reply from the original authors or the statement “Reply declined.”

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