MPH student Kate Klein sat down with Darius Tandon, PhD, Associate Professor in Medical Social Sciences, Associate Director of the Center for Community Health and Editor of the Progress in Community Health Partnership journal.
KK: Tell me a little about the projects you are working on right now?
DT: I am a psychologist and the common thread of the research that I’m doing is integrating mental health interventions into non-mental health settings. Right now I have two main research focuses.
First, I am working in young adult and adolescent mental health. We do a lot with job training programs to try to integrate mental health support into job training programs. The people in these training programs are not in school and not in the work force and they have mental health needs. We have done a lot to implement and test interventions – not just on enhancing mental health outcomes, but also to show other positive effects. For example, if you improve mental health outcomes we hope to also influence other key things like completion of a GED or getting hired and maintaining a job.
The second area I am working in is in the area of postpartum depression. Most of this work is with home visitation programs. Home visiting programs are in place in every state and are increasingly supported through the Affordable Care Act to serve pregnant women and women with young children. Though these programs are very successful in some respects, we know from our previous research that these programs don’t do the best job with psychosocial risks for women, such as postpartum depression. Since we have home visitation workers going into the home, we are trying to use them to identify women who are most at risk for depression and intervening to prevent worsening of depressive symptoms. Also we try to intervene to give mothers the skills to help manage stress and improve their mood. Training home visitation workers rather than mental health professionals is a more sustainable model over time. We are conducting trainings for home visitors across Illinois on our intervention, which is called the Mothers and Babies Course. We have already trained about 30 home visitors from Chicago and will be training home visitors working in other parts of Illinois over the next few months. Ultimately, we will train 60 home visitors. Once trained, home visitors can transmit our curriculum material to mothers in either a group course or in fifteen-minute segments during a home visit. We are also starting the process of an evaluation of how effective these trained home visitors are in delivering the intervention and also the effect of the intervention on maternal mental health outcomes over time.
Related to this, I am a faculty expert for a home visiting quality improvement project sponsored by the Federal Maternal and Child Health Bureau. They are trying to accelerate home visiting programs’ ability to work in developmental screening, breast-feeding, and maternal depression. I am helping them to think about systematic screening for postpartum depression, what to do if a woman tests positive for depression, and interventions to prevent and treat depression. Through that initiative, we hope to work with other home visiting programs around the country incorporating our Mothers and Babies curriculum.
KK: How did you get to this topic area –what was the route that brought you here?
DT: There is a lot of work that shows that if you are referring clients to a mental health provider, there is limited uptake on the part of the individual. Over time I realized that you had to take the interventions to where the clients already are. The reason we selected job training programs and home visiting programs is because that’s where many individuals are who need mental health services and interventions. There are so many kids that drop out of schools and where do they go? They go to job training programs. The same thing with home visiting. Home visiting is becoming one of the best ways in which women come to the attention of the health system. One of the reasons we like working with home visiting programs is because they have an extended relationship with their clients.
I came to Northwestern seven months ago because there were lots of opportunities to do community-based work here at Northwestern. There is a growing recognition that researchers need to be collaborating with key stakeholders at multiple phases in the process of research. Stakeholder engagement should not be optional, but part of the fabric of what researchers are doing. The Center for Community Health does a lot of things to change the way health researchers engage with the community. For example, we are trying to encourage medical researchers to disseminate their research to community and clinical settings so that medical and public health professionals are using the evidenced-based interventions that we know work. Under the umbrella of the Center for Community Health, we also have the Alliance for Research in Chicagoland Communities (ARCC) and the Practiced Based Research Network.
KK: Who are you working with (both internally and externally –individuals, organizations, and sponsors)?
DT: As you know I wear two hats, one as a researcher the other as the Associate Director of the Center for Community Health. In each of these areas I am working with many people, both inside and outside the university.
At the Center for Community Health, the Director, Ron Ackermann and I are responsible for leading the Center for Community Health in exciting and new directions in thinking about where things are going. There are a number of faculty and community stakeholders involved as part of our steering committees.
With the postpartum depression research, I am connecting with people who are likely collaborators. For example, I see a research connection with Katherine Wisner, Director of the Asher Center for the Study and Treatment of Depressive Disorders and the faculty affiliated with that center. To date their work has been largely done in hospital or clinic-based populations and they are interested in expanding beyond that to promote depression research in community settings.
I am also looking forward to expanding our research to explore how our intervention for maternal mental health outcomes is also affecting parent-child interaction outcomes and child health outcomes, such as social-emotional development and language development.
KK: Do you have any future projects planned?
DT: I have a few things in the hopper right now. First, we submitted a big grant to the Patient Centered Outcomes Research Institute (PCORI), a national entity funded through the Affordable Care Act. That project would let women chose two modalities of the Mothers and Babies project; either an individual or group-based format. In the long term we hope to expand this research.
We are also interested in integrating our Mothers and Babies group format into community health centers in Chicago. Many community health centers see women who are pregnant and just delivered, so this is a good place to stage the intervention. There are two community health center networks here in Chicago, and we hope to partner with the centers as recruitment and intervention sites.
We are also looking to start to do more adolescent and young adult work here in Illinois. We have encouraging findings from our work in Baltimore, and we hope to integrate it into more job training programs in Illinois.
KK: What should the wider NU community know about your work?
DT: I am someone who is trying to take mental health interventions into non-mental health settings because those are often the settings in which people are comfortable receiving services leading to better outcomes.
KK: Are you interested in collaborating with others on these projects. If so, along what lines and how should people reach out if they are interested?
DT: Absolutely. I think there is going to be a lot of really interesting research questions that we will be able to explore with the postpartum depression research, some related to maternal health outcomes, some to parent/child outcomes, some to child outcomes. There are lots of studies we could do under the heading of implementation science. For example, what are we learning about how you train, supervise, and disseminate interventions on a wide basis to numerous community programs.
I am also the editor of a journal, Progress in Community Health Partnership, which is a peer-reviewed journal solely focused on community-based participatory research. The journal is in its 8th year of publishing and has shown increases in the number of submissions each year. We are always looking for people to submit and review articles. Students, faculty and community stakeholders can submit manuscripts. We also bring on postdocs as editorial fellows.
Anyone interested in partnerships can contact me at my email,
firstname.lastname@example.org or the following websites:
Center for Community Heath: http://www.feinberg.northwestern.edu/sites/cch/
Progress in Community Health Partnership journal website: http://www.press.jhu.edu/journals/progress_in_community_health_partnerships/