MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
Glasgow Caledonian University, Psychology, Social Work and Allied Health Professionals, School of Health and Life Sciences, Glasgow, United Kingdom.
PLoS One. 2019 Apr 16;14(4):e0215461. doi: 10.1371/journal.pone.0215461. eCollection 2019.
Understanding why parenting programmes work or do not work, and for whom, is crucial for development of more effective parenting interventions. In this paper we focus on a specific component of Mellow Bumps: reflection on one's own childhood/past/life. We explore how this component was implemented, how participants engaged with it, the facilitating and constraining factors shaping this, whether and how it appeared to work, or not, and for whom. The paper analyses data from the Process Evaluation of the Trial of Healthy Relationships Initiatives for the Very Early years, which is evaluating two antenatal interventions delivered to vulnerable women, one of which is Mellow Bumps. Data were collected from January 2014 to June 2018 for 28 groups, 108 participants and 24 facilitators in a comprehensive and rigorous Process Evaluation designed to complement the Outcome Evaluation. Data were gathered at various time points using multiple methods, and were synthesised to triangulate findings. The reflective component was implemented with fidelity and participants engaged with it to varying degrees, dependent largely on the coherence of the group. Patchy attendance compromised the coherence of some groups, with the development of rapport, which is key to delivering reflective exercises, more difficult when group composition varied from week to week. Where there was a coherent group, powerful mechanisms of change, leading to stress reduction, included: relief through unburdening, empowerment through support given and received, reduced isolation through sharing anxieties, and control through self-care advice. A minority of highly vulnerable mothers seemed not to benefit from the reflective exercises and were marginalised within their groups. In order to minimise potential harmful effects of such exercises, allocation of participants to groups should strive to maximise group homogeneity. More research is needed to explore how very vulnerable parents can be supported in attending parenting interventions from start to finish.
了解育儿计划为何有效或无效，以及对谁有效，对于开发更有效的育儿干预措施至关重要。在本文中，我们专注于 Mellow Bumps 的一个特定组成部分：反思自己的童年/过去/生活。我们探讨了该组成部分是如何实施的，参与者如何参与其中，塑造这种情况的促进和制约因素，以及它是否有效，以及对谁有效。本文分析了针对非常早期的健康关系倡议试验的过程评估的数据，该试验正在评估两项针对弱势妇女的产前干预措施，其中一项是 Mellow Bumps。数据于 2014 年 1 月至 2018 年 6 月期间收集，涉及 28 个小组、108 名参与者和 24 名协调员，该过程评估是为了补充结果评估而进行的全面而严格的评估。数据使用多种方法在不同时间点收集，并进行综合分析以验证研究结果。反思性组成部分得到了忠实的实施，参与者的参与程度各不相同，主要取决于小组的凝聚力。由于出勤率不稳定，一些小组的凝聚力受到影响，而建立融洽关系的难度更大，因为小组的组成每周都在变化。在有凝聚力的小组中，一些强大的变革机制发挥了作用，包括：通过倾诉减轻压力、通过获得和给予支持获得赋权、通过分享焦虑减轻孤立感、通过自我保健建议获得控制感。少数非常脆弱的母亲似乎没有从反思性练习中受益，并在小组中被边缘化。为了最大限度地减少此类练习的潜在有害影响，应努力使参与者在分组时最大程度地实现小组同质性。需要进一步研究如何支持非常脆弱的父母全程参加育儿干预措施。
