Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Research article

Facilitating Perinatal Access to Resources and Support (PeARS): a feasibility study with external pilot of a novel intervention

Authors: Pauline Slade, Melanie Dembinsky, Katie Bristow, Kim Garthwaite, Amy Mahdi, Annette James, Atif Rahman, Soo Downe

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Login to get access

Abstract

Background

Up to 50% of women in areas of high socio-economic deprivation are at risk of developing depressive symptoms in pregnancy. Feeling well supported, can facilitate good mental health perinatally. A brief, innovative intervention to facilitate access to support and resources was developed and tested. This included one antenatal and one postnatal session, each with three evidence-based components: i) support from a non-professional peer to enable a woman to identify her needs; ii) information about local community services and signposting; and iii) development of a personalised If–Then plan to access that support. The aims were to evaluate the intervention and research methods for feasibility and acceptability for perinatal women, maternity care providers and peers, and provide preliminary effectiveness indications.

Methods

Pregnant women living in an area of high deprivation were recruited from community-based antenatal clinics and randomised to intervention or control condition (a booklet about local resources). Outcome measures included women’s use of community services by 34 + weeks gestation and 6 months postnatally; mental health and wellbeing measures, and plan implementation. Interviews and focus groups were conducted with women participants, providers, and peers. Data were analysed using framework analysis. Recruitment and retention of peers and participants, intervention fidelity, and acceptability of outcome measures were recorded.

Results

Peer facilitators could be recruited, trained, retained and provide the intervention with fidelity. One hundred twenty six women were recruited and randomised, 85% lived in the 1% most deprived UK areas. Recruitment constituted 39% of those eligible, improving to 54% after midwifery liaison. Sixty five percent were retained at 6 months postnatally. Women welcomed the intervention, and found it helpful to plan access to community services. Providers strongly supported the intervention philosophy and integrated this easily into services. The study was not powered to detect significant group differences but there were positive trends in community service use, particularly postnatally. No differences were evident in mental health and wellbeing.

Conclusions

This intervention was well received and easily integrated into existing services. Women living in highly deprived areas could be recruited, randomised and retained. Measures were acceptable. Peer facilitators were successfully trained and retained. Full effectiveness studies are warranted.
Appendix
Available only for authorised users
Footnotes
1
Children’s centres in the UK are financed by local councils to provide a range of services for families from conception to age 5.
 
Literature
1.
go back to reference Mckee MD, Cunningham M, Jankowski KRB, Zayas L. Health-related functional status in pregnancy: Relationship to depression and social support in a multi-ethnic population. Obstet Gynecol. 2001;97(6):988–93.PubMed Mckee MD, Cunningham M, Jankowski KRB, Zayas L. Health-related functional status in pregnancy: Relationship to depression and social support in a multi-ethnic population. Obstet Gynecol. 2001;97(6):988–93.PubMed
3.
go back to reference Brugha TS, Smith J, Austin J, Bankart J, Patterson M, Lovett C, et al. Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial. Psychol Med. 2016;46(2):345-56. Brugha TS, Smith J, Austin J, Bankart J, Patterson M, Lovett C, et al. Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial. Psychol Med. 2016;46(2):345-56.
4.
go back to reference Huang R, Yan C, Tian Y, Lei B, Yang D, Liu D, et al. Effectiveness of peer support intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord. 2020;276(June):788–96.CrossRef Huang R, Yan C, Tian Y, Lei B, Yang D, Liu D, et al. Effectiveness of peer support intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord. 2020;276(June):788–96.CrossRef
5.
go back to reference M. M. Fair Society, Healthy Lives: The Marmot review. Strategic review of health inequalities in England post 2010. London: 2010. M. M. Fair Society, Healthy Lives: The Marmot review. Strategic review of health inequalities in England post 2010. London: 2010.
6.
go back to reference Grigoriadis S, Vonder Porten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review. J Clin Psychiatry. 2013;74:e321-41. Grigoriadis S, Vonder Porten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review. J Clin Psychiatry. 2013;74:e321-41.
7.
go back to reference Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012–24.CrossRef Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012–24.CrossRef
8.
go back to reference Edge D. Perinatal Mental Health of Balck and Minority ethnic Women: A review of current provision in England Scotland and Wales. National Mental Health Equalities Programme; 2011. Edge D. Perinatal Mental Health of Balck and Minority ethnic Women: A review of current provision in England Scotland and Wales. National Mental Health Equalities Programme; 2011.
9.
go back to reference Gnzashb SE. Engaging women who are depressed and economically disadvantaged in mental health treatment. Soc Work. 2007;52(1):295–308. Gnzashb SE. Engaging women who are depressed and economically disadvantaged in mental health treatment. Soc Work. 2007;52(1):295–308.
11.
go back to reference Atif N, Lovell K, Husain N, Sikander S, Patel V, Rahman A. Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study. Int J Ment Health Syst. 2016;10(1):1–12.CrossRef Atif N, Lovell K, Husain N, Sikander S, Patel V, Rahman A. Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study. Int J Ment Health Syst. 2016;10(1):1–12.CrossRef
13.
go back to reference Lamb J, Dowrick C, Burroughs H, Beatty S, Edwards S, Bristow K, et al. Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups. Heal Expect. 2015;18(6):2865–79.CrossRef Lamb J, Dowrick C, Burroughs H, Beatty S, Edwards S, Bristow K, et al. Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups. Heal Expect. 2015;18(6):2865–79.CrossRef
14.
go back to reference Martin J, Sheeran P, Slade P, Wright A, Dibble T. Implementation Intention Formation Reduces Consultations for Emergency Contraception and Pregnancy Testing Among Teenage Women. Heal Psychol. 2009;28(6):762-9. Martin J, Sheeran P, Slade P, Wright A, Dibble T. Implementation Intention Formation Reduces Consultations for Emergency Contraception and Pregnancy Testing Among Teenage Women. Heal Psychol. 2009;28(6):762-9.
15.
go back to reference Martin J, Sheeran P, Slade P, Wright A, Dibble T. Durable effects of implementation intentions: reduced rates of confirmed pregnancy at 2 years. Heal Psychol. 2011;30(3):368-73. Martin J, Sheeran P, Slade P, Wright A, Dibble T. Durable effects of implementation intentions: reduced rates of confirmed pregnancy at 2 years. Heal Psychol. 2011;30(3):368-73.
16.
go back to reference Gollwitzer PM. Implementation intentions: strong effects of simple plans. Am Psychol. 1999;54(7):493–503.CrossRef Gollwitzer PM. Implementation intentions: strong effects of simple plans. Am Psychol. 1999;54(7):493–503.CrossRef
17.
go back to reference Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38(06):69–119.CrossRef Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38(06):69–119.CrossRef
18.
go back to reference Dennis CL. Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. Int J Nurs Stud. 2010;47(5):560–8.CrossRef Dennis CL. Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. Int J Nurs Stud. 2010;47(5):560–8.CrossRef
19.
go back to reference Webb TL, Sheeran P. How do implementation intentions promote goal attainment? A test of component processes. J Exp Soc Psychol. 2007;43(2):295–302.CrossRef Webb TL, Sheeran P. How do implementation intentions promote goal attainment? A test of component processes. J Exp Soc Psychol. 2007;43(2):295–302.CrossRef
20.
go back to reference Armitage CJ. Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: a randomized exploratory trial. Heal Psychol. 2009;28:545–53.CrossRef Armitage CJ. Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: a randomized exploratory trial. Heal Psychol. 2009;28:545–53.CrossRef
22.
go back to reference Slade P and the PT. Perinatal Access to Resources and Support (PeARS Study) Improving access to support for perinatal women through peer facilitation: a feasibility study with external pilot. Liverpool: Report to Collaboration for Leadershipfor Applied Health Research and Care, North West Coast; 2018. p. 1–44. Slade P and the PT. Perinatal Access to Resources and Support (PeARS Study) Improving access to support for perinatal women through peer facilitation: a feasibility study with external pilot. Liverpool: Report to Collaboration for Leadershipfor Applied Health Research and Care, North West Coast; 2018. p. 1–44.
23.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Obstet Gynecol Scand. 1983;67(6):361–70. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Obstet Gynecol Scand. 1983;67(6):361–70.
24.
go back to reference Tennant T Hillier Fishwick L, Platt R JSE and PJ. The WEMWBS:development and UK Validation. Health Qual Life Outcomes. 2007;1–13. Tennant T Hillier Fishwick L, Platt R JSE and PJ. The WEMWBS:development and UK Validation. Health Qual Life Outcomes. 2007;1–13.
25.
go back to reference Marks M. Client Services Receipt Inventory- Postnatal depression version (CSRI-PND). London: Institute of Psychiatry. Marks M. Client Services Receipt Inventory- Postnatal depression version (CSRI-PND). London: Institute of Psychiatry.
26.
go back to reference Oates J, Oates JM, Gervai J. Mothers’ object relational scales. Milan: Poster presented at the XIth European Conference on Developmental Psychology; 2003. Oates J, Oates JM, Gervai J. Mothers’ object relational scales. Milan: Poster presented at the XIth European Conference on Developmental Psychology; 2003.
27.
go back to reference Loyd BH, Abidin RR. Revision of the parenting stress index. J Pediatr Psychol. 1985;10(2):169–77.CrossRef Loyd BH, Abidin RR. Revision of the parenting stress index. J Pediatr Psychol. 1985;10(2):169–77.CrossRef
28.
go back to reference Guest G, MacQueen KM, Namey EE. Applied thematic analysis. 2012. Guest G, MacQueen KM, Namey EE. Applied thematic analysis. 2012.
29.
go back to reference Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, Gyte G, Hinder S, Miller V, Slade P, Trepel D, Weeks A, Whorwell P, Williamson M. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG. 2015;122(9):1226–34. Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, Gyte G, Hinder S, Miller V, Slade P, Trepel D, Weeks A, Whorwell P, Williamson M. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG. 2015;122(9):1226–34.
30.
go back to reference Downe S, Finlayson K, Walsh D, Lavender T. Weighing up and balancing out: a meta-synthesis of barriers to antenatal care for marginalised women in high-income countries. BJOG An Int J Obstet Gynaecol. 2009;116(4):518–29. Downe S, Finlayson K, Walsh D, Lavender T. Weighing up and balancing out: a meta-synthesis of barriers to antenatal care for marginalised women in high-income countries. BJOG An Int J Obstet Gynaecol. 2009;116(4):518–29.
31.
go back to reference Cleland CL, Hunter RF, Tully MA, Scott D, Kee F, Donnelly M, et al. Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: A qualitative study. Int J Behav Nutr Phys Act. 2014;11(1):1–9.CrossRef Cleland CL, Hunter RF, Tully MA, Scott D, Kee F, Donnelly M, et al. Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: A qualitative study. Int J Behav Nutr Phys Act. 2014;11(1):1–9.CrossRef
33.
go back to reference Kildea S, Simcock G, Liu A, Elgbeili G, Laplante DP, Kahler A, et al. Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing : the Queensland flood study. 2018. p. 203–14. Kildea S, Simcock G, Liu A, Elgbeili G, Laplante DP, Kahler A, et al. Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing : the Queensland flood study. 2018. p. 203–14.
34.
go back to reference Bickerdike L, Booth A, Wilson PM, Farley K, Wright K. Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open. 2017;7:e013384. Bickerdike L, Booth A, Wilson PM, Farley K, Wright K. Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open. 2017;7:e013384.
35.
go back to reference Thomson LJ, Camic PM, Chatterjee HJ. Social Prescribing: A Review of community referral schemes. London: University College London; 2015. Thomson LJ, Camic PM, Chatterjee HJ. Social Prescribing: A Review of community referral schemes. London: University College London; 2015.
Metadata
Title
Facilitating Perinatal Access to Resources and Support (PeARS): a feasibility study with external pilot of a novel intervention
Authors
Pauline Slade
Melanie Dembinsky
Katie Bristow
Kim Garthwaite
Amy Mahdi
Annette James
Atif Rahman
Soo Downe
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04112-w

Other articles of this Issue 1/2021

BMC Pregnancy and Childbirth 1/2021 Go to the issue