A lead physician and nursing staff person were selected
by each site. Those 2 individuals attended a training
session held in Dallas, Texas. Human subjects training,
general study procedures, such as completing and faxing
to the central site informed consent, enrollment logs,
and distribution of the initial survey packets, were completed
with all sites together. The sites were then told
their randomization status and separated by intervention
and control sites. Control sites practiced informed
consent and worked to develop a site-specifi c implementation
plan. The intervention sites spent an additional
half-day on general information pertaining to postpartum
depression, on screening and diagnosis, as well as
training and practice of nursing telephone calls, and on
scoring and using PHQ-9 in case studies. All sites were
given a prepared set of slides that shortened the training
materials. The control sites were given a 1-hour program
they presented to all clinicians and other staff members
of their practices. The prepared slides for the intervention
practices required 2 sessions, 1 hour each, with a
refresher session 6 weeks later. Central study staff was
on the telephone during all of the presentations within
the study sites to support and answer questions.