4. Research Question In what way is the routine use in practice of the Edinburgh Postnatal Depression Scale (EPDS) helping health visitors and others to provide effective care to mothers with babies?

5. Methods Survey Focus groups Individual interviews

6. Population N=300 Groups (2) Diagnosis of postnatal depression No Diagnosis of postnatal depression N=10 For Interviewing DESIGN

7. Ethical Considerations Minimise risks (Clinical experiences) Inform practice Data protection (Storage) Fewer than anticipated sample

8. Why Ethical Approval University standards for research good conduct Demands of the research governance framework Comparisons between groups Age of consent Confidentiality

9. Access ( Approval ) School Health Ethical committee LREC Trust Research Committee Caldicott Guardian Health visitors (meetings) Meetings with Sure Start staff Mothers

10. Implications for Researchers Length of securing ethical approval Unrealistic expectations from research commissioners What does failure to secure approval mean? Lack of knowledge of the research process Unequal demands on health sector researchers

11. Postnatal depression-Clinical definition It refers to a non psychotic depression occurring in the first six to twelve weeks after delivery Clinical features are similar to clinical depression Symptoms believed to be hormonal during labour and physiology of childbirth No difference in experience (Evans et al 2001)

12. Edinburgh Postnatal Depression Scale (EPDS) Developed by Cox et al (1982) Administered by professional staff (HV) Time line (5, 8, 12 &26 weeks after birth) 10 questions and is self reporting A score of 12/13 or over = PND