Community Health Worker-Delivered Interventions for Perinatal Mental Health in the United States: A Scoping Review.

Abstract

Background: Maternal health in the United States is in crisis, and perinatal mental health conditions are emerging as a critical contributor to maternal morbidity and mortality. Perinatal mood and anxiety disorders (PMADs) encompass a range of mental health disorders experienced during pregnancy and 1 year after delivery. Expanding the perinatal mental health workforce to include paraprofessionals could help address a national shortage of mental health professionals.

Objective: This scoping review aims to investigate the literature on perinatal mental health interventions delivered by community health workers (CHWs) or paraprofessionals in the United States.

Methods: Studies on interventions addressing perinatal mental health were included if delivered by CHWs or paraprofessionals in the United States. Seven databases were searched via EBSCO through August 29, 2025. No publication year limits were applied. Results were exported to Zotero for deduplication, Catchii for screening, and Excel for data extraction and analysis. Risk of bias was not assessed.

Results: After removing 4148 duplicates from the 7524 records identified, 3376 records were screened, and 13 studies met the inclusion criteria. CHW-delivered interventions for PMADs in the United States varied in design, content, and implementation. Most were initiated during the antenatal period, extended postnatally, and targeted primary prevention of depression symptoms. Ten studies evaluated outcomes among predominantly low-income, Latina, or Black mothers in urban environments. Interventions enhanced social support, cognitive, emotional, behavioral, parenting, and practical skills. Intervention results varied. Most studies reported positive effects: all nonexperimental designs found statistically significant improvements in depressive symptoms, and many experimental designs demonstrated statistically significant improvements in depressive symptoms among women receiving adequate intervention dosage.

Conclusions: This review expands knowledge of perinatal mental health interventions delivered by CHWs and health paraprofessionals in the United States, including information about populations served, CHWs, intervention characteristics, and outcomes. Gaps in evidence and recommendations for future research are presented.