Helping patients make decisions about treatment during the perinatal period is a critical process for the birth person and their provider. Dr. Simone Vigod, MD, explains how her team developed a patient decision aid. Dr. Vigod also shares the research benefits of large datasets.
Dr. Simone Vigod (MD 2003, FRCPC 2009) is a Professor in the Department of Psychiatry, Temerty Faculty of Medicine at the University of Toronto, and Head of the Department of Psychiatry at Women’s College Hospital, one of the University of Toronto’s nine fully affiliated academic health sciences centers. Dr. Vigod is a leading expert in perinatal mood disorders and has conducted some of the largest studies worldwide on maternal mental illness around the time of pregnancy. Mental illness at this life stage poses unique risks to mothers and their children at a critical juncture in both of their lives. Her research is helping raise awareness about gaps in access to specialized perinatal mental healthcare and identifying vulnerable populations where these gaps are most prominent. She also designs and evaluates novel health system interventions to improve access to and care uptake for affected women. Dr. Vigod leads a clinical research program at Women’s College Hospital as a Senior Scientist and the Shirley A. Brown Memorial Chair in Women’s Mental Health Research at the Women’s College Research Institute. She is a Senior Adjunct Scientist at ICES in Toronto, Ontario, where population-level administrative health data for her epidemiological studies are securely held.
Helping patients make decisions about treatment during the perinatal period is a critical process for the birth person and their provider. Dr. Simone Vigod, MD, explains how her team developed a patient decision aid. Dr. Vigod also shares the research benefits of large datasets.
Dr. Simone Vigod (MD 2003, FRCPC 2009) is a Professor in the Department of Psychiatry, Temerty Faculty of Medicine at the University of Toronto, and Head of the Department of Psychiatry at Women’s College Hospital, one of the University of Toronto’s nine fully affiliated academic health sciences centers. Dr. Vigod is a leading expert in perinatal mood disorders and has conducted some of the largest studies worldwide on maternal mental illness around the time of pregnancy. Mental illness at this life stage poses unique risks to mothers and their children at a critical juncture in both of their lives. Her research is helping raise awareness about gaps in access to specialized perinatal mental healthcare and identifying vulnerable populations where these gaps are most prominent. She also designs and evaluates novel health system interventions to improve access to and care uptake for affected women. Dr. Vigod leads a clinical research program at Women’s College Hospital as a Senior Scientist and the Shirley A. Brown Memorial Chair in Women’s Mental Health Research at the Women’s College Research Institute. She is a Senior Adjunct Scientist at ICES in Toronto, Ontario, where population-level administrative health data for her epidemiological studies are securely held.
MONA Podcast Dr. Simone Vigod Transcript
Dr. Lara-Cinisomo [00:00:04] Welcome to Studying Perinatal Well-being, the podcast of the Marcé of North America. This bilingual monthly podcast will allow new and experienced researchers, practitioners, students and community members to care about the latest research and community actions on perinatal well-being. I'm Dr. Sandraluz Lara-Cinisomo, your host. Dr. Simone Vigod is a professor in the Department of Psychiatry at the University of Toronto and head of the Department of Psychiatry at Women's College Hospital, one of the University of Toronto's nine fully affiliated Academic Health Sciences Centers. Dr. Vigod is a leading expert in perinatal mood disorders and has conducted some of the largest studies worldwide on maternal mental illness around the time of pregnancy. Her research is helping raise awareness about gaps in access to specialized perinatal mental health care and identifying vulnerable populations where these gaps are most prominent. She also designed and evaluates novel health system interventions to improve access to and care uptake for affected women. Dr. Vigod leads a clinical research program at Women's College Hospital as a senior scientist and the Shirley A. Brown Memorial chair in Women's Mental Health Research at the Women's College Research Institute. She is a senior acting scientist at ICES in Toronto, Ontario, where population level administrative data for her epidemiological studies are securely housed. Well, welcome, Dr. Vigod. Thank you for joining us.
Dr. Vigod [00:01:39] Oh, thank you. Sandraluz I'm very, very happy to be here.
Dr. Lara-Cinisomo [00:01:44] Well, we appreciate it. Well, let's start by learning a little bit about you. How did you become interested in perinatal mental health?
Dr. Vigod [00:01:50] Oh, it's such a good question and such a long time ago now. You know, it's funny. Several of my colleagues in the field, I think, have a really similar story. You know, when I was in medical school, I was very interested in psychiatry and I was interested in obstetrics and gynecology, and I was interested in pediatrics. And I think, you know, in the end, I really kind of ended up being at the, at the intersection of all three. It's really a field where you're, you're really doing all of those things.
Dr. Lara-Cinisomo [00:02:24] Well, that's wonderful. Well, your research focuses on several areas, a lot of intersections, for sure. For example, you focus on maternal schizophrenia, lactation in women with schizophrenia, bipolar disorder, depression, medications in pregnancy, as well as alternative treatments. And you also design online decision tools about medication for people with severe depression. I want to begin with maternal schizophrenia. What is it and how does it differ from schizophrenia in the general population?
Dr. Vigod [00:02:53] You know, that's such a good question. And I think the part of how I became interested in this is, you know, really anyone with any mental health issue who, you know, who can become pregnant. Right. And so, you know, a lot of people were already when I started my career where already there were a lot of people who were interested in concepts like postpartum depression and then now more so, postpartum anxiety. But I think as a psychiatrist who was trained, you know, not only in focusing on the more common mental health issues, but also on the more like serious mental health issues like schizophrenia, I really felt like I might have something, you know, more like more unique to contribute in that area. And so, you know, when we talk about pregnancy among people with schizophrenia, usually we're talking about people who, you know, schizophrenia affects people often in their late teens, early twenties. Right. So we're talking about people who may have been diagnosed with that as a chronic illness and then are in the reproductive decision making time of their lives. And so it's not that it's a different kind of illness. It's it's that how do we help people to have successful pregnancy and parenting experiences. And they also, you know, are faced with having a chronic and more severe mental health issue.
Dr. Lara-Cinisomo [00:04:24] Yeah. And your research looks at some of those experiences in pregnancy, but also post childbirth, for example, you looked at skin to skin contact and breastfeeding initiation and mothers with schizophrenia, but also comparing them to mothers without schizophrenia. Many of your studies include large samples in the thousands, which I think is really important, especially given this specialized area. But I also want to ask about these large studies. In this one study in particular, you had a sample of over 4000 infants of women with schizophrenia and nearly 300,000 infants of women without schizophrenia. Why are large studies important when we're looking at schizophrenia?
Dr. Vigod [00:05:10] Well, you know, like we were saying, I mean, schizophrenia affects a lot of people, probably affects about one in 100 people. Right. But when you start to think about how can we figure out, like, what's the population health, right, it would take you probably quite a long time, maybe even several years to be able to recruit enough people with schizophrenia who become pregnant, who, you know, who are having babies and finding them. It would take you quite a long time to, to recruit enough people to get meaningful information. And, you know, with smaller samples, we can do really great work on people's experiences, people's experiences of care, people's experiences of things. But if we're trying to understand, like on a population level, who do we need help? Where might there be sort of differences between groups that we need to understand better? We can use large population data sets and in Ontario, in Canada, so Ontario is the largest population in Canada, it's about 15 million people. So about 30 million people live in Canada. So about about a 10th of the size of the U.S. and Ontario is one of our biggest provinces. But because we have universal health care, we have, you know, people it's encrypted, it's all anonymized, but we can connectpeople's health care visits to each other. So we know, you know, someone has been seen in the health care system for schizophrenia. We know when people have had babies and we have you know, the study that you're talking about is we have a birth registry that actually has information about our people planning to breastfeed, Aare they getting skin to skin care? You know, we don't have everything. But this is you know, this is really important work because, you know, even if, let's say, some moms with schizophrenia are, maybe they're planning not to breastfeed because, for example, they might be on medications and they don't want to breastfeed, that doesn't mean you can't have skin to skin. Right. So if they're not having skin to skin to the same rates, then we would want to say, well, how come? Is it because their baby got taken away to the NICU because there was a problem, or is it because they're very unwell maybe psychiatrically? Or could it actually be because somebody is discriminating against them and, you know, saying that maybe that they can't have the skin to skin or something? So sometimes from these really large data sets, we don't know exactly why something is happening, but we can look at differences between groups and say, wait a minute, hang on a second. Let's look at this in a little bit more detail to try and understand it. Then we can that can lead us to interventions or supports or programs or services that can improve and make differences between groups smaller. And then the sort of neat thing is that we could measure it on a population level again and make sure that we're really going in the right direction.
Dr. Lara-Cinisomo [00:08:12] Yeah, and it's important to remember that if we have anonymous data, doesn't mean that these people are not meaningful. It just means we can access a large dataset that will allow us to answer many questions in a very efficient way. Probably funding is another component that makes large data sets sometimes unreachable. Can you talk a little bit about the funding opportunities and strategies that you tend to use to help you advance your line of research?
Dr. Vigod [00:08:42] Yeah, I mean, you know, in general, when we when we're able to use data that's already been collected, it costs a lot less than if we had to go and find individual study participants and follow them over a long time. So from a cost perspective, it actually can be really efficient. The thing to remember is just like everything, this stuff is one data point and it can point us in the right direction of what things to look at and where to focus our efforts. And sometimes, you know, it can actually help you get funding for another study, right. You know, we we were looking, for example, at intimate partner violence among pregnant people with schizophrenia. And what we found actually is that pregnantpeople with schizophrenia are they are actually asked while they're pregnant as much as anybody else, and they do disclose more than others like that there might be some problem going on. Right. So we know that now on a population level, that's really strong evidence to then go and say to a funder, you know, we need to look at this population in more detail because we need to know, like, why are pregnant people with schizophrenia at risk? How can we help them? And then it can really be, you know, so something that doesn't cost a lot, that it doesn't give you all the answers, but it can really support your argument to go and say, we really need to look at this more closely so we can help our whole population.
Dr. Lara-Cinisomo [00:10:16] Yeah. And it can help us identify some gaps in treatment, maybe gaps in the kind of questions that we're asking either in the research or patients. And your work also includes this decision tool that I talked about around treatment. How do those two things work together in terms of large data sets and then developing a decision tool?
Dr. Vigod [00:10:38] Yeah, I mean, you know, I think the, again, this is sort of the the specific things that I'm trained to know about as a psychiatrist. Like the medication part, right. And thinking about, you know, how can one use that, our expertise and I work clinically in a in a clinic in a big city, you know, and so people who get referred to me, it's a little better now that we do a lot more video care. But, you know, before we had a lot of video care, you know, people could come and see me if they lived close by, if their doctor knew about our program. Right. It wasn't really a very fair and equitable way to get to get information to people. And, you know, and also, there aren't a lot of you know, do you know how many articles are published about the safety of medications for psychiatric reasons and pregnancy? Like every year? I think once I went and I just Googled it or put it into one of those databases. And, you know, there's like 40 or 50 articles published in a year of different quality and people don't you know, people really need some guidance on how to interpret that. And it's hard to expect that, for example, a midwife or a family physician or an obstetrician, like they have a whole bunch of other things of someone's pregnancy related health to take care of. They can't be reading, you know, 50 or 60 of these articles a year. So it's a really specialized area. So about probably close to ten years ago now, we said, you know, there's has to be a way that we can help support patients and their clinicians who have to make a decision about, do I stay on my medication during pregnancy or do I not stay on my medication? What are the different considerations? Because that's not always 100%. You know, there's benefits and there's potential risks, right? And sometimes going with no treatment is a big risk. And so people really want to know, like, what are the chances that this will happen? What are the chances that will happen? And so decision tools are decision AIDS. They don't just provide information, but they also help people go through exercises to sort of say, okay, which of these risks and benefits is really important to me? And then they can really start weighing things. And they also say, and who's, you know, is anyone pressuring me like my is my doctor? Do I feel like my doctor's pressuring me, my partner, you know, so these decision tools that have a lot of evidence behind them around how to help people make decisions when there's no for sure right answer. Right. How do you make people more comfortable with their decision? So we decided to create one online. And what was neat was that when we first tested the online tool, we compared it just in our own clinic between people who saw one of us and people who didn't. And it showed that actually it didn't help people who saw one of us. It didn't do any better than just seeing one of us. Right. Like adding it on to one at one of the specialized psychiatrists didn't necessarily help people. People got what they needed from the psychiatrist. But then we tested it across Canada among people who didn't have access to a specialized psychiatrist who had access to just like their regular doctor. And in that group, it really helped people's decision making comfort a lot. And then that led to a big cross-Canada study to say, well, does it not only help people's decision making comfort, but does it actually help improve outcomes? Like if you use this tool, are you more likely to be well throughout your pregnancy and postpartum? So we're not saying which decision people should make in terms of their medications. We're trying to help them make the best possible decision for them. So I'm hopeful that by next year we'll have the results out from that. It's about 400 people across Canada.
Dr. Lara-Cinisomo [00:14:31] Wow. It probably also increases self-efficacy of the patient. Have you looked at that to see whether it helps the patient feel more confident about their medication decisions and timing of whether they're going to change their medication or stop taking their medication?
Dr. Vigod [00:14:47] Yeah, we measure we use something they call it the decisional conflict scale, and it has all of these subscales that are exactly what you're talking about. Like, how confident do I feel in my decision? How satisfied do I feel in my decision? You know, the theory is that if people are making what is a more comfortable decision for them, they're probably more likely to make sort of the quote unquote right or best decision for them, because when you're really conflicted and you're not sure what to do, sometimes you delay decisions. Right. Which when you're pregnant, you don't really like, you have to make a decision. Right. And if you delay a decision, you could potentially get more and more ill, let's say, while you're delaying that decision, you know, or you or you end up making a decision that you're that's not really right for you and then you end up not doing well. So, yeah, that is exactly what we're trying to do here, not to dictate what someone should do or not. We can't always predict the future and have the exact right answer. It's people have to say, well, you know, I have to decide what pieces of this are more important to me. And, you know, that's why we have some people will say, I'll never take medication during pregnancy. Right. And other people who have a different sort of level of ability to say, well, listen, you know what, the chances it's a really low chance that this medication will be problematic. And actually, if I don't take it's a really high chance things aren't going to go well. Right.
Dr. Lara-Cinisomo [00:16:12] Yeah. And I'm wondering about the experience for the provider. What is that like to go through this decision process with the patient? I imagine that it probably helps them feel more at ease. Maybe they feel more in concert with the patient in terms of the decision that they make together. Yeah.
Dr. Vigod [00:16:31] It's really supposed to help support shared decision making and identify. What are the barriers to making a decision?
Dr. Lara-Cinisomo [00:16:39] Yeah. Is it available in different languages?
Dr. Vigod [00:16:41] We hope that what we will be doing as we, as we finish the trial is doing exactly that that we're looking into right now. You know, where we’ll host it, who will update the data that's in it. What languages can we have it translated into? We've had a lot of interest from across the world in the UK. They modified it a little bit to just have a little bit of language that was a little bit different even from our English in Canada. But, you know, it should be amenable to being able to share, to translate it, being able to have slightly different, you know, and then we can think about it. This one specifically is about anti-depressants for depression, but we could think about using the same model for other kinds of medications.
Dr. Lara-Cinisomo [00:17:27] Absolutely. And in thinking about maybe parents trying to make a decision for child child's treatment, what do they you know, what medications do they use? What procedures do they pursue? What are some of the options that are available for their children as well and helping them to see all of the information and make a more informed decision that they could be more comfortable with?
Dr. Vigod [00:17:48] Yeah, exactly.
Dr. Lara-Cinisomo [00:17:50] Yeah, definitely lots of applications. I'm thinking also that, you know, it could be applied in the behavioral economics sphere, right. Trying to decide where do you invest your resources, but also trying to curtail some what economists call decision errors or in terms of when people make decisions about their money, but also behavior, and that can include medication use. So lots and lots of applications for others to see. And if we can make way if it's accessible in different languages, then definitely I can see lots and lots of applications for it. You talked about medication use in pregnancy. One of your and maybe what a person decides to do before they become pregnant. And one of your studies looked at that very question in terms of discontinuing medication or using their medication or continuing to stay on medication after they become pregnant. And what you found is that in preconception, the participants said, yes, I will continue, but the people who were pregnant said that they wouldn't want to continue their medication. What do you think factors into those differences?
Dr. Vigod [00:18:56] You know, I mean, I'm not a specialist around, you know, decision making writ large, but a lot of the literature in that area would suggest that that makes sense, right? Because it's sometimes hard to make. You know, when you're planning the pregnancy, you're still making sort of a hypothetical decision. And then when that decision is right in front of you, sometimes people make different decisions. There's a lot of pressure out there for pregnant people. Right. You know, people feel pressure externally that others are, you know, potentially judging the decision they're making. And then and people put a lot of pressure on themselves. And sometimes, you know, one thing that we found in one of our other decision making studies is that people are more worried that they're going to do something like commit an error than they are if they just don't do something, they get make an error by omission or an error by not doing something. There's something about physically doing something that feels more scary than not doing something. But sometimes that's not quite right. Right. And and that's what our that's what our decision tool tries to help people do is see, okay, what are the consequences of picking this treatment or that treatment and what are the consequences of picking no treatment? Because there might be consequences of that, too.
Dr. Lara-Cinisomo [00:20:15] Yeah, that's right. That's right. And so I think where you're what I'm hearing is that people are afraid to make these errors or to regret a decision. So regret aversion is a is a big driver, it sounds like, in in these countries, because there could be some significant consequences. And it sounds like a lot needs to be taken into account. I want to bring it back to this conversation about this decision tool because you probably had to make some decisions about what you were going to include. But also there must have been some challenges that you experienced in putting together a tool and I’m thinking about our listeners who might be interested in pursuing something similar. Can you talk about any kinds of challenges or considerations that went into developing this kind of a tool?
Dr. Vigod [00:21:00] Absolutely. So I mean, I think one one thing is just about funding, right? Like, you can't just I mean, you know, ten years ago when we started developing this, I think it was even harder. I think now there are probably more, you know, templates you can make, use and make to do things. But at the time, you know, we had to find, I'm not a tech person, right? But we had to find somebody to actually do the web development and all of that and and find funding and convince funders, you know, to develop it in a scholarly way. Probably the most rewarding part was all of the, Our patients are persons of my experience who worked on it with us along the way. I remember when we had our very first version, it wasn't fully built out, but it was, you know, and they make what did they call it, like basically making pictures of what it would look like and the not even a prototype, not even something you click through, but just the ideas. We were trying to make it so fancy with, you know, this and that and clicking here and drawings and pictures. And we had this idea of like a traffic light system where people could be, you know, this really bothers me. It goes into the red or like down into the green. And when we went through it with our first sort of these idea that these idea boards with our first groups of patients like their persons that they'd be experiencing, they seemed hesitant. Right. And then finally, one of the people said to me, you know, we don't really need all these bells and whistles, like actually what we want. We actually what I want, she said, is like, I want this to be as simple as possible. I want it to go through it as if I was talking to you or somebody else, like just check out through it.
Dr. Lara-Cinisomo [00:22:51] More real life.
Dr. Vigod [00:22:52] Right. And, you know, in almost like conversationally. And then we ended up it was really neat because we had a discussion about how different people need different levels of information. Some people want to know absolutely everything, and other people just want the highlights. So that was a really neat part of the development because what we ended up with is something where you can go when you go into the tool for some of the really heavy information pieces, you have the highlights, but you can scroll, you know, roll over on it and then a pop up will come with more information. So the electronic way was really neat because we were able to layer it. And so people who just wanted to see the very bottom line could see it, and people who wanted to see a whole paragraph had more information, you know, can get that, too. So I think that was a really neat part of of doing it online. But when we went for the first time after we built it and we were ready to do a pilot test, the first time we submitted it to the Canadian Institutes for Health Research, the reviewers came back and they said, This is too simple, it's too boring. People aren't going to like it. People aren't going to use it. Then we went back and we wrote more. It had our our people on our panel write more letters and say, No, no, actually, this is what we wanted them to design because we were essentially trying to ask for money to test it to see if people would use it. But it was really interesting how the reviewers immediately thought, you know, this isn't fancy enough, but actually we have really high usability and from the, you know, initial results from our big trial that we're doing now, like I think something like over 80% of people log in and get to the end of the tool. And if for anyone who knows things about use of online tools, that's really, really high. They're in a clinical trial. So we just posted this online. Maybe that wouldn't be the case, but that's really high for a user engagement with the tool.
Dr. Lara-Cinisomo [00:25:01] Definitely. And you talked about engaging individuals with lived experience, and that really highlights the importance of who's driving these tools and who is making decisions about what they're going to look like, what information is going to be available to them. And it really raises the the point that we need to make this a community conversation about what patients need and making sure that their perspective lived experiences, but also their needs are being addressed.
Dr. Vigod [00:25:30] That's right. And it's in fact called a patient decision aid. So we definitely should remember that, right?
Dr. Lara-Cinisomo [00:25:38] Absolutely. Absolutely. Well, I really appreciate your willingness to answer my questions about this, because I imagine our listeners are going to be very interested in you're providing some tips as well as really key information about this patient decision aid that we just talked about. If it's okay with you, I'd like to move our conversation into things that may be happening outside of the office. But related and congratulations on your new role as the Marcé of North America president. You're the first to represent Canada, and MONA includes Mexico, the U.S. and Canada. So that's very exciting. And we just had the MONA conference in October of 2023. I'm hoping people will be listening to this podcast for years to come. So what are some of your goals for MONA?
Dr. Vigod [00:26:26] Well, I'm really first, I would say I'm really excited to to take on this role and to be able to represent the Canadian contingent. You know, lots of people who are interested in in perinatal mental health. It's an exciting time for Canada right now. Our our national government has now put this area as a priority. And increasing access to perinatal mental health care is a priority right now, which is really huge for us. I think that it's been more of a priority in the US, so we're it's a really exciting time right now and there's a lot of engagement in Canada. So I'm really excited that, you know, we do the MONA conference every two years. So we'll have October or November 2025 and we'll have a conference in Toronto and Canada for the first time. So really excited to be able to showcase that. You know, and I think over my time as president, I'm really hoping that to build on the shoulders of the giants that that came before. MONA is is not that old of an organization. And so, you know, we are really at a point now where we have a critical mass and number of people. And so we can really start building out more in terms of our education space, our research space. But I think, you know, at the core, we're a society focused on science and that our our responsibility can be to bring the North American community together, to say, you know, what is the rigorous work that needs to be done so that we can inform our countries, our governments, our institutions, our funders, like how to give the best, you know, prevention and treatment around perinatal mental health. And I think, you know, we've really you know, things have got have really blossomed. And so I think that will be that will really be a focus of like, what are we doing in a scholarly manner to inform that in Mexico and the U.S. and Canada and collectively together so that we can really lead and and improve the health of our pregnant people and postpartum people and their families. So I'm just really excited. Might not sound that exciting, but, you know, to carry the torch and to just really focus on that, on the science and on on having the science drive action.
Dr. Lara-Cinisomo [00:29:01] Yeah. And what you're, I think it's very exciting and I think our listeners will agree and it's like you said, it's an opportunity to start bringing the different countries together, not just in these conversations we have in an ongoing basis, but in terms of, you know, limiting the boundaries around conversations but also access and proximity to each other. I think that that's very exciting so that we can feel closer in this joint effort. So, you know, I think it's wonderful that we'll have a conference in 2025 in Toronto, Canada. I think that's going to draw a lot of people. So I.
Dr. Vigod [00:29:35] Hope so.
Dr. Lara-Cinisomo [00:29:36] Yeah, very exciting. You know, one of the questions I have, I hear you talking about meeting with patients and meeting patient needs and then research. And I'm wondering how you manage it all with taking on this leadership role for this nonprofit. And I know you have many, many hats. Some of our listeners may want to venture out and explore some volunteer opportunities because the MONA board is a volunteer role. What suggestions do you have and what can you share about how you're able to manage those kinds of different, sometimes very different activities?
Dr. Vigod [00:30:11] You know, I think what I would say is that it really takes a village and, you know, the group around MONA really is a village. I think people do a lot of things behind the scenes, and I think there's also a lot of acceptance about people being able to do and contribute what they can. Right. And, you know, I think it's a wonderful opportunity if people want to raise their hand. I think it is a very you know, I found when I started, it's such a welcoming community where people really, truly are able to able to take you and appreciate for what you like, for what you're able to give at that particular time and really, you know, don't need to fit people into a box. And I would say, you know, that's how I manage, right? I manage by having a network and I manage by having support and by making, you know, making this realizing that nobody's superhuman in that we all have to kind of make decisions about what to prioritize because there are only so many hours in a day and we all only have so much capacity. And, you know, I think as maybe particularly as female leaders, we also need to model that. So I'm like, I'm glad that you asked that because it really sometimes you can look at someone and think, oh, they do everything like that. They must be sort ofsuperhuman. And I'm not, right. But I think the truth that nobody is. And, you know, we we have to we have to be conscious of what we can do. And but at the same time, you know, taking one step forward is better than not taking any. Right? So we don't need to feel like we have to do everything.
Dr. Lara-Cinisomo [00:31:54] Yeah. And thinking about taking a step forward, there might be a listener who's interested in pursuing research in perinatal mental health. What advice or suggestions do you have for that person? That person might be a community member, they might be a student. They might be a practitioner who's interested in diving into research. What suggestions do you have?
Dr. Vigod [00:32:13] There are different ways to be involved in research, right? You know, and so I think it's it is really hard if you don't have an academic position or job where, you know, you have time protected and you're specifically hired to get training for research and you're part of an institution that supports research. You know, I think I have seen times where people really want to get involved in research but feel they, you know, want to lead a project, for example, but actually don't aren't in that environment that will help generate a network for that. So I think it is I think it's really important to, to seek out collaborations and seek out what people are doing. And, you know, again, being being involved in research doesn't mean having to lead something huge from the beginning. Right. It can be a little bit of training or, you know, asking to be part of someone, something that someone is working on to really give a sense. And then that starts to and then you start to meet people and that starts to open up opportunities.
Dr. Lara-Cinisomo [00:33:22] Yeah. And I think that's where the conference can be a really good opportunity for people to think about the kinds of research they want to participate in, who might be potential collaborators. And if it's someone who's a practitioner who might be interested in doing a little bit of research, they can identify the different kinds of work that is happening. Because at the conference we talk about, you know, qualitative, large scale studies, mid-sized studies, projects that are just taking off. And so it could be an opportunity for people who are interested in pursuing research to start a conversation with someone.
Dr. Vigod [00:33:58] Yeah, and I think it goes back to what we said in the beginning, right? There's not one research study that's going to give us all the answers to everything.
Dr. Lara-Cinisomo [00:34:06] Yeah, that's a really excellent point. Well, this has been really wonderful. Before we end, is there anything else you want to share about your research or MONA or any other work around perinatal well-being?
Dr. Vigod [00:34:17] You know, I hope that this has been informative, but it was really neat to talk about the development of the patient decision aid, because I think that's that's really been like a large focus that and then thinking about, you know, other alternative interventions that we can think about for people who, you know, in the end say I don't want I really don't want to use medication or maybe therapy, which is really the first line treatment, you know, maybe didn't work well enough, like what I do. So I'm also thinking in the future about, you know, different different options for treatment. And I guess this is my cup of tea to be talking about these issues. And I hope that people will listen and, you know, know that there are people trying to help.
Dr. Lara-Cinisomo [00:35:02] Yeah. This has been wonderful. Thank you so much, Simone. I appreciate your time.
Dr. Vigod [00:35:07] Okay. Thank you so much, Sandraluz, for the interview.
Dr. Lara-Cinisomo [00:35:11] Thank you for joining Studying Perinatal Well-being. Please see our show notes on the MONA Podcast website for more information about today's guest. We always look for great perinatal well-being students, community members, researchers and practitioners to interview. So please email your suggestions to
MONAPodcast@Marcenortham.com. That's MONAPodcast@Marcenortham.com Until next time, practice compassion for yourself and others.