Baumgartner Joy Noel, Ali Mohammed, Gallis John A, Lillie Margaret, Owusu Raymond, Abubakr-Bibilazu Safiyatu, Adam Haliq, Aborigo Raymond, McEwan Elena, Zhou Yunji, Kim Eunsoo Timothy, Mackness Jessica, Williams John Koku Awoonor, Hembling John
University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC 27516, USA.
Duke Global Health Institute, Duke University, Durham, NC, USA.
Glob Ment Health (Camb). 2021 May 26;8:e18. doi: 10.1017/gmh.2021.15. eCollection 2021.
Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.
This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.
In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.
This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.
照顾者的心理健康与儿童早期发展相关，但仍需要更有力的证据来证明基于社区的干预措施可预防产妇抑郁并优化幼儿的社会情感发展。这项基于加纳北部的整群随机对照试验（cRCT）的目的是评估由非专业顾问提供的、基于小组的母婴综合课程和幼儿发展（iMBC/ECD）项目对以下方面的影响：（1）2岁以下儿童母亲的心理健康；（2）其子女的社会情感发展。
这项cRCT将32个妇女小组随机分组——16个小组接受iMBC/ECD内容（干预组），16个小组接受一般健康教育内容（对照组）。在基线、干预结束后立即以及干预后8个月进行调查。主要结局是产妇抑郁[患者健康问卷（PHQ-9）]，次要结局是儿童的社会情感发展[年龄与阶段问卷：社会情感（ASQ:SE-2）]。还对33名利益相关者进行了定性访谈。
共有374名参与者在基线时怀着首个孩子时登记入组，19%的人认可中度/重度抑郁。其中，266人（71.1%）完成了干预后8个月的调查（基线后约19个月）。iMBC/ECD对PHQ-9和ASQ:SE-2评分没有显著影响。然而，在大多数情况下结果有利于干预组。iMBC的参与者对该项目高度满意，但利益相关者的定性反馈表明存在一些实施方面的挑战。
这项实际评估没有得出显著结果；然而，两组干预后的抑郁水平都非常低（3%）。未来的研究应更广泛地研究妇女小组对产后心理健康的潜在影响，采用不同的内容。
