New Mothers in a New Country: Understanding Postpartum Depression among Recent Immigrant and Canadian-Born Chinese Women
Objective: The objectives of this study are three-fold: (1) to determine the prevalence of postpartum depression (PPD), patterns of inception, and psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) among recent immigrant Chinese mothers; (2) to examine the relationships between recent immigrant status, PPD, acculturation, acculturative stress, social support, income, and the practice of traditional postpartum rituals; and (3) to determine patterns of PPD help-seeking behaviours and barriers to health services among recent immigrant Chinese mothers.
Design Overview: The proposed study will incorporate a longitudinal design where recently immigrated Chinese mothers will be followed for the first year postpartum; a Canadian-born cohort of Chinese mothers will also be followed as a control group for comparisons. Following a comprehensive recruitment plan, a research assistant (matched on maternal language ability) via telephone will provide all potentially eligible women with a detailed study explanation and ensure eligibility. Mothers providing verbal consent to participate will complete baseline information within 4 weeks postpartum and be mailed the study explanation and two copies of the consent form; a postage-paid, addressed envelope will be included to return the signed consent form to the research assistant. All mothers (N = 500) will be followed–up at 12, 24, and 52 weeks postpartum via telephone by trained research assistants.
Relevance: The study results will make substantive contributions in seven areas: (1) provide information about PPD prevalence and inception rates among recently immigrated and Canadian-born Chinese women; (2) establish the sensitivity and specificity of the EPDS (the most widely-used international measure to assess depressive symptoms in postpartum women) in detecting PPD among these Chinese mothers; (3) advance our understanding of the relationship between recent immigrant status, the acculturation process, and PPD; (4) determine which traditional postpartum rituals are maintained post-migration and the effect of these practices on the development of PPD; (5) investigate health service utilization barriers and help-seeking behaviours related to PPD; (6) promote cultural sensitivity among health professionals; and (7) guide the development of a randomized controlled trial to evaluate a culturally-sensitive PPD intervention.