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The ´óÏóÊÓƵCross-Sectional Innovation to Improve Rural Postpartum Mental Health Challenge aimed to improve postpartum mental health care for rural American families. ´óÏóÊÓƵsought narratives and proposals regarding cross-cutting solutions that encompass digital healthcare and non-traditional partners to ensure that rural families can receive treatment and support for postpartum mental health problems.

About and Challenge Goal

One in seven mothers experiences a postpartum mental health condition, defined as the onset of depression or anxiety within 1 year of birth. Rural women and families face barriers to accessing adequate mental health care for postpartum mental health problems, including cost, transportation, and childcare barriers. The COVID-19 pandemic, with its disruption of traditional employment and social supports, made this an especially timely topic, as women’s birth circumstances were different than they may have envisioned throughout their pregnancies. Prior research suggests that higher levels of stressors during pregnancy and the delivery period are associated with greater prevalence of postpartum depression.

´óÏóÊÓƵsought both success stories that highlighted community achievements and program proposals that demonstrated innovative planning for community action to improve postpartum mental health that ´óÏóÊÓƵcould share with healthcare systems, healthcare professionals, local and State policymakers, Federal partners, and the public. Eligible solvers were healthcare providers; community-based organizations and clubs; faith-based groups; cooperative extension services; schools; hospitals; local health departments; and State, territorial, and tribal organizations that highlighted successful or promising programmatic interventions to improve rural postpartum mental health. Programmatic models could leverage existing community assets and initiatives (e.g., Healthy Start, Head Start, 4H Healthy Living) or created them de novo.

Timeline and Prize Amounts

´óÏóÊÓƵhosted this challenge as a single-phase competition with two categories: success stories and proposals. Challengers could submit to only one category. The challenge ran from May to September 2020, with winners announced during Rural Heath Month (November 2020).

Total Cash Prize: $175,000

Success Story Category: Five winners of $15,000 each

Program Proposal Category: Two winners of $50,000 each

Evaluation Criteria

Submissions for each category were rated based on equally weighted achievement of five competencies: Community Assessment, Partnership, Logic Model, Evidence of Meeting Programmatic Goals, and Capacity to Disseminate. They were required to clearly state the category of entry and provide evidence that the community is located in a rural area.

Expert Advisors

All applications were reviewed by at least two Expert Advisors, who scored them based on the review criteria and provided comments about the application. Scores/comments were compiled, and a ranked summary provided to ´óÏóÊÓƵstaff. AHRQ/HHS selected winners based on quantitative and qualitative assessments.

Challenge Winners

´óÏóÊÓƵawarded two Program Proposals $50,000 each, and three Success Stories $25,000 each.

The two Program Proposal winners are:

1. St. Peter's Health Maternal Mental Health Program from St. Peter's Health in Helena, Montana. Their solution focuses on identifying at-risk individuals through screening for alcohol, substance use, depression, anxiety, and social determinants of health to connect women to resources and appropriate care early in pregnancy. 
2. Digital Health Coaching to Address Postpartum Depression in Central Alabama from Pack Health in Birmingham, Alabama. Their solution will build out an existing digital health coaching platform which combines person-to-person engagement with a National Health and Wellness Board Certified Health Advisor, along with digital delivery of evidence-based content via text, email, or mobile application, based on the participant's access and preference.

The three Success Story winners are:

1. The Massachusetts Child Psychiatry Access Program (MCPAP) for Moms that serves all of rural Massachusetts. The program provides education, consultation, and resources and referrals to build the capacity of frontline medical providers to address perinatal mental health and substance use disorders, and has enrolled 76% of obstetric practices in the State.
2. The Postpartum Resource Group from Flathead County, Montana. The group hosts several programs including in-person support groups, online peer support forums, a "village network," and a scholarship program.
3. The Art Heals: Wellness Workshops for Postpartum Women program from the Linn, Benton, and Lincoln counties of Oregon. This partnership between Samaritan Health Services, Jordan Schnitzer Museum of Art at the University of Oregon, Stahlbush Island Farms, Mind Body Medicine, and Oregon State University offers acrylic painting, nutritional, and mindfulness classes for rural postpartum moms.