Mums 4 Mums: structured telephone peer-support for women experiencing postnatal depression. Pilot and exploratory RCT of its clinical and cost effectiveness

Abstract

BackgroundPostnatal depression (PND) can be experienced by 13% of women who give birth, and such women often exhibit disabling symptoms, which can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later capacity for affect regulation. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. The Mums4Mums study aims to evaluate the impact of telephone peer-support for women experiencing PND.Methods/DesignThe study design adopts the MRC framework for the development and evaluation of complex interventions. Health visitors in Warwickshire and Coventry Primary Care Trusts are screening potential participants at the 8-week postnatal check using either the Edinburgh Postnatal Depression Scale (EPDS > = 10) or the three Whooley questions recommended by NICE (http://guidance.nice.org.uk/CG45). The Mums4Mums telephone support intervention is being delivered by trained peer-supporters over a period of four months. The primary outcome is depressive symptomatology as measured by the Edinburgh Postnatal Depression Scale. Secondary outcomes include mother-child interaction, dyadic adjustment, parenting sense of competence scale, and self-efficacy. Maternal perceptions of the telephone peer-support are being assessed using semi-structured interviews following the completion of the intervention.DiscussionThe proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. PND), testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities. The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical and cost effectiveness of telephone based peer-support for PND.Trial registrationISRCTN: ISRCTN91450073. The study has received a major funding grant from National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) programme (ref: PB-PG-0407-13232).

A scoping review of mental health prevention and intervention initiatives for infants and preschoolers at risk for socio-emotional difficulties

“…The child and/or family were also considered in some studies to be “at-risk” due to the presence of adverse family circumstances including teen pregnancy/teen mothers [56–58] or caregiver attachment issues [59–61]. The two most common adverse family conditions cited in the research were parental mental health and addictions issues [31, 53, 62–70], in particular maternal depression [52, 60, 63, 71–81] and low income or poverty [30, 34, 82–92]. Risk was also determined by the family residing in “at-risk” communities [93–96] or due to the child and/or family’s involvement in certain programs or agencies, typically used as a proxy for their “at-risk” status, for example, enrolment in early Head Start programs or similar [52, 62, 97–113] or involvement with child welfare services [114–118].…”

Can We Predict the Evolution of Depressive Symptoms, Adjustment, and Perceived Social Support of Pregnant Women from Their Personality Characteristics? a Technology-Supported Longitudinal Study

“…Because social support was inversely associated with depressive symptoms and maladjustment, these results support the idea that intervention programs should be addressed to women at risk for poor perceived social support (i.e., those with a low E and high N and P profile). Again, ICT solutions might be useful tools to provide social support to women during pregnancy [55].…”

Information and support needs during recovery from postpartum psychosis

“…Hearing the stories of others enabled women to externalise responsibility for their symptoms and behaviours during the illness, form predictions about their future, and feel less alone in their experience. Telephone-based peer support has been reported to be an effective intervention for women with Postnatal Depression (Caramlau et al 2011;Dennis 2003). Since PP is less common than other forms of postnatal mental illness, specialist PP support groups in local healthcare settings are impractical and might not be beneficial when women are feeling socially vulnerable.…”