scholarly journals Evaluation of a Technology-Based Peer-Support Intervention Program for Preventing Postnatal Depression (Part 2): Qualitative Study

10.2196/12915 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e12915 ◽  
Author(s):  
Shefaly Shorey ◽  
Esperanza Debby Ng

Background Social support is known to reduce risks of postnatal depression (PND) and improve maternal emotional well-being. However, the Asian cultural context is often neglected when appraising maternal needs and mothers’ preferences for social support. While many preventive efforts have experimented with technology, professionals, and paraprofessionals in providing social support to mothers in need, most studies determined the effectiveness of their interventions through quantitative measurements of maternal outcomes. Experiences and feedback from both participants and administrators are rarely discussed, especially in an Asian setting. Objective The goal of the research was to evaluate the postnatal experiences of Asian mothers at risk of PND and the perceptions of peer volunteers regarding a technology-based peer-support intervention program (PIP). Methods A qualitative semistructured interview was conducted with 20 Asian mothers at risk of depression (10 from the control group and 10 from the intervention group) and 19 peer volunteers from a randomized controlled trial. The PIP included weekly correspondence between peer volunteers and mothers through any telecommunication means over 4 weeks. All interviews were approximately 30 to 60 minutes long, audiotaped, transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Standards of Reporting Trials checklist. Results Two overarching themes comprising five subthemes were generated: postnatal experience (a bouncy ride, a way forward) and evaluation of the PIP (valuable, flexible, and supportive program; building blocks of a good relationship; and lessons learned and the road ahead). Mothers from both the control and interventions groups were generally satisfied with hospital care and the support received from family. They also shared similar breastfeeding challenges and needs for more informed decisions and follow-up support from the hospital. However, mothers who received the PIP tended to have more positive outlooks of their birth experiences. Overall, peer volunteers and mothers involved in the PIP found the PIP useful and expressed satisfaction with the program’s flexibility. They also shared their personal takeaways, the qualities of their friendships, and the need for extended correspondence time and recommended outreach to non–at-risk mothers. Conclusions The positive endorsement of the PIP by peer volunteers and mothers suggests the success of the PIP in maintaining positive maternal emotional well-being during the postpartum period. With the help of technology, hospitals can easily provide additional peer support to at-risk mothers in addition to existing standard care offered to these mothers. Trial Registration ISRCTN Registry ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.9416

2018 ◽  
Author(s):  
Shefaly Shorey ◽  
Esperanza Debby Ng

BACKGROUND Social support is known to reduce risks of postnatal depression (PND) and improve maternal emotional well-being. However, the Asian cultural context is often neglected when appraising maternal needs and mothers’ preferences for social support. While many preventive efforts have experimented with technology, professionals, and paraprofessionals in providing social support to mothers in need, most studies determined the effectiveness of their interventions through quantitative measurements of maternal outcomes. Experiences and feedback from both participants and administrators are rarely discussed, especially in an Asian setting. OBJECTIVE The goal of the research was to evaluate the postnatal experiences of Asian mothers at risk of PND and the perceptions of peer volunteers regarding a technology-based peer-support intervention program (PIP). METHODS A qualitative semistructured interview was conducted with 20 Asian mothers at risk of depression (10 from the control group and 10 from the intervention group) and 19 peer volunteers from a randomized controlled trial. The PIP included weekly correspondence between peer volunteers and mothers through any telecommunication means over 4 weeks. All interviews were approximately 30 to 60 minutes long, audiotaped, transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Standards of Reporting Trials checklist. RESULTS Two overarching themes comprising five subthemes were generated: postnatal experience (a bouncy ride, a way forward) and evaluation of the PIP (valuable, flexible, and supportive program; building blocks of a good relationship; and lessons learned and the road ahead). Mothers from both the control and interventions groups were generally satisfied with hospital care and the support received from family. They also shared similar breastfeeding challenges and needs for more informed decisions and follow-up support from the hospital. However, mothers who received the PIP tended to have more positive outlooks of their birth experiences. Overall, peer volunteers and mothers involved in the PIP found the PIP useful and expressed satisfaction with the program’s flexibility. They also shared their personal takeaways, the qualities of their friendships, and the need for extended correspondence time and recommended outreach to non–at-risk mothers. CONCLUSIONS The positive endorsement of the PIP by peer volunteers and mothers suggests the success of the PIP in maintaining positive maternal emotional well-being during the postpartum period. With the help of technology, hospitals can easily provide additional peer support to at-risk mothers in addition to existing standard care offered to these mothers. CLINICALTRIAL ISRCTN Registry ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/resprot.9416


2018 ◽  
Author(s):  
Shefaly Shorey ◽  
Cornelia Yin Ing Chee ◽  
Esperanza Debby Ng ◽  
Ying Lau ◽  
Cindy-Lee Dennis ◽  
...  

BACKGROUND The frenzy of postbirth events often takes a toll on mothers’ mental well-being, leaving them susceptible to postpartum psychological disorders such as postnatal depression (PND). Social support has been found to be effective in restoring the emotional well-being of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after effects of childbirth and to promote healthier maternal well-being. OBJECTIVE This study aimed to evaluate the effectiveness of a technology-based peer-support intervention program (PIP) on maternal outcomes during the early postpartum period. METHODS A randomized, parallel-armed controlled trial was conducted. The study recruited 138 mothers (69 in intervention group, 69 in control group) at risk of PND from a tertiary hospital in Singapore. To support these mothers, 20 peer volunteers were recruited by word of mouth and trained by a psychiatrist in social support skills before the intervention commenced. The 4-week–long intervention included a weekly follow-up with a peer volunteer through phone calls or text messages. The intervention group received peer support in addition to the standard care offered by the hospital. The control group only received postnatal standard care. Maternal outcomes (PND, postnatal anxiety [PNA], loneliness, and perceived social support) were measured with reliable and valid instruments. Data were collected immediately postpartum, at 1 month postpartum and at 3 months postpartum. The general linear model was used to compare the groups for postpartum percentage changes in the outcome variables at first and third months, and the linear mixed model was used to compare the trend over the study period. RESULTS There was a statistically significant difference in Edinburgh Postnatal Depression Scale scores (d=–2.11; 95% CI −4.0 to −0.3; P=.03) between the intervention and control groups at 3 months postpartum after adjusting for covariates. The intervention group had a significant change over time compared with the control group. CONCLUSIONS The technology-based PIP was found to be effective in reducing the risk of PND among new mothers and showed a generally positive trend in reducing PNA and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. A further long-term evaluation of the PIP on maternal and family outcomes and its cost-effectiveness is needed to inform clinical practices. CLINICALTRIAL ISRCTN Registry ISRCTN14864807; https://www.isrctn.com/ISRCTN14864807 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/resprot.9416


2017 ◽  
Author(s):  
Shefaly Shorey ◽  
Cornelia Chee ◽  
Yap-Seng Chong ◽  
Esperanza Debby Ng ◽  
Ying Lau ◽  
...  

BACKGROUND Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. OBJECTIVE This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period. METHODS A randomized controlled 2-group pretest and repeated posttest experimental design will be used. The study will recruit 118 mothers from the postnatal wards of a tertiary public hospital in Singapore. Eligible mothers will be randomly allocated to receive either the peer support intervention program or routine perinatal care from the hospital. Peer volunteers will be mothers who have experienced self-reported depression and will be receiving face-to-face training to support new mothers at risk of depression. Outcome measures include postnatal depression, anxiety, loneliness, and social support. Data will be collected at immediate postnatal period (day of discharge from the hospital), at fourth week and twelfth week post childbirth. RESULTS The recruitment and training of peer support volunteers (N=20) ended in June 2017, whereas recruitment of study participants commenced in July 2017 and is still ongoing. The current recruitment for new mothers stands at 73, with 36 in the control group and 37 in the intervention group. Data collection is projected to be completed by May 2018. CONCLUSIONS This study will identify a potentially effective and clinically useful method to prevent postnatal depression in new mothers, which is the top cause of maternal morbidity. Receiving social support from others who share similar experiences may enhance the positive parenting experiences of mothers, which in turn can improve the psychosocial well-being of the mothers, tighten mother-child bond, and enhance overall family dynamics for mothers and infants. CLINICALTRIAL International Standard Randomized Controlled Trial Number ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807 (Archived by WebCite at http://www.webcitation.org/6xtBNvBTX)


10.2196/12410 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e12410 ◽  
Author(s):  
Shefaly Shorey ◽  
Cornelia Yin Ing Chee ◽  
Esperanza Debby Ng ◽  
Ying Lau ◽  
Cindy-Lee Dennis ◽  
...  

Background The frenzy of postbirth events often takes a toll on mothers’ mental well-being, leaving them susceptible to postpartum psychological disorders such as postnatal depression (PND). Social support has been found to be effective in restoring the emotional well-being of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after effects of childbirth and to promote healthier maternal well-being. Objective This study aimed to evaluate the effectiveness of a technology-based peer-support intervention program (PIP) on maternal outcomes during the early postpartum period. Methods A randomized, parallel-armed controlled trial was conducted. The study recruited 138 mothers (69 in intervention group, 69 in control group) at risk of PND from a tertiary hospital in Singapore. To support these mothers, 20 peer volunteers were recruited by word of mouth and trained by a psychiatrist in social support skills before the intervention commenced. The 4-week–long intervention included a weekly follow-up with a peer volunteer through phone calls or text messages. The intervention group received peer support in addition to the standard care offered by the hospital. The control group only received postnatal standard care. Maternal outcomes (PND, postnatal anxiety [PNA], loneliness, and perceived social support) were measured with reliable and valid instruments. Data were collected immediately postpartum, at 1 month postpartum and at 3 months postpartum. The general linear model was used to compare the groups for postpartum percentage changes in the outcome variables at first and third months, and the linear mixed model was used to compare the trend over the study period. Results There was a statistically significant difference in Edinburgh Postnatal Depression Scale scores (d=–2.11; 95% CI −4.0 to −0.3; P=.03) between the intervention and control groups at 3 months postpartum after adjusting for covariates. The intervention group had a significant change over time compared with the control group. Conclusions The technology-based PIP was found to be effective in reducing the risk of PND among new mothers and showed a generally positive trend in reducing PNA and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. A further long-term evaluation of the PIP on maternal and family outcomes and its cost-effectiveness is needed to inform clinical practices. Trial Registration ISRCTN Registry ISRCTN14864807; https://www.isrctn.com/ISRCTN14864807 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.9416


Author(s):  
Robert M. Portman ◽  
Andrew R. Levy ◽  
Anthony J. Maher ◽  
Stuart J. Fairclough

Perceived social support opportunities are central to successful exercise referral scheme (ERS) client experiences. However, there remains a lack of guidance on how ERSs can embed social support opportunities within their provision. This study presents retrospective acceptability findings from a 12-week social-identity-informed peer support intervention to enhance perceived social support among clients of an English ERS. Five peer volunteers were recruited, trained, and deployed in supervised ERS sessions across two sites. Peers assisted exercise referral officers (EROs) by providing supplementary practical, informational, motivational, and emotional support to ERS clients. Individual semi-structured interviews were conducted with peers (n = 4), EROs (n = 2), and clients (n = 5) and analysed thematically. The analysis identified three primary themes. The first theme detailed how EROs utilised peer volunteers to supplement the ERS client experience. This theme delineated peer roles within the ERS context and identified salient individual peer characteristics that contributed to their success. The second theme described peer acceptability among the various stakeholders. Peers were valued for their ability to reduce burden on EROs and to enhance perceptions of comfort among ERS clients. The final theme presented participant feedback regarding how the intervention may be further refined and enhanced. Peers represented a cost-effective and acceptable means of providing auxiliary social support to ERS clients. Moving forward, the structured integration of peers can improve the accessibility of social support among ERS participants, thus facilitating better rates of ERS completion.


2017 ◽  
Vol 17 (5) ◽  
pp. 408-417 ◽  
Author(s):  
Tracey JF Colella ◽  
Kathryn King-Shier

Background and aim: Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). Methods: A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3–4 days of discharge. Results: Although a significant difference was detected in pre-intervention depression scores at discharge, there were no differences between groups in changes in depression scores at six weeks ( p=0.08), 12 weeks (0.49) or over time ( p=0.51); and no significant differences in perceived social support scores over time ( p=0.94). At 12 weeks, the intervention group had significantly lower incidence of health services utilization (family physician ( p=0.02) and emergency room ( p=0.04)). Conclusions: Healthcare providers need to continue to investigate novel interventions to enhance social support and reduce depression in cardiac patients.


2021 ◽  
Author(s):  
GeckHong Yeo ◽  
Weining Chang ◽  
Li Neng Lee ◽  
Matt Oon ◽  
Dean Ho

BACKGROUND Background: The burgeoning mental health issues among emerging adults (ages 19 to 25) worldwide has fueled concerns about their widespread experiences of anxiety and depression. With the onset of the COVID-19 pandemic, emerging studies are being directed towards the development and deployment of digital peer emotional disclosure and support for the psychological well-being of emerging adults. However, much remains to be explored regarding implementation and clinical effectiveness, how best to conduct digital peer support intervention for emerging adults’ psychological well-being, and the associated mechanism of change. OBJECTIVE Objective: This protocol delineates a randomized controlled trial for evaluating the implementation and clinical effectiveness of Acceset, a digital peer support intervention for emerging adult mental well-being with two components. First, the digital peer support training equips befrienders (i.e., peers who provide support) in harnessing four active ingredients—Mattering, selfhood, compassion, and mindfulness—to provide effective peer support for seekers (peers who seek support). Second, the Acceset platform incorporates digital markers of psychological well-being, hinges on peer emotional disclosure process and entails community engagement. METHODS Methods: 100 participants (aged 19 to 25) from the National University of Singapore (NUS) will be recruited and randomly allocated into two arms. Arm 1 (n = 50) seekers will engage with the Acceset platform for a period of 3 weeks, together with befrienders (n = 30) and moderators (n = 30). Arm 2 (n = 50) a control group will be placed on a waitlist for Acceset intervention. Both seekers and befrienders will be monitored using a questionnaire battery at 4 time points: baseline (before the intervention), 3 weeks (the end of the intervention), 6 weeks and 9 weeks (to measure carry over effects). The implementation outcomes on the two components of the intervention will be adoption and fidelity evaluation of the digital peer support training curriculum and the feasibility and acceptability of the Acceset platform. The clinical outcomes will include Mattering, self-hood, compassion, mindfulness, perceived social support and psychological well-being scores. RESULTS Results: This protocol has received approval by the Institutional Ethics Review Board of NUS in October 2021. Recruitment will commence in January 2022. We expect data collection and analyses to be completed in June 2022. The aim is to publish the preliminary results in December 2022. The size effect will be estimated using the Cohen d index with a significance level of .05 (95% reliability) and a conventional 80% power statistic. CONCLUSIONS Conclusions: This protocol considers a novel digital peer support intervention—Acceset—that incorporates active ingredients and digital markers of emerging adult mental well-being. Through the validation of Acceset intervention, this study defines the parameters and conditions for digital peer support intervention for emerging adults. CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT05083676


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