Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial
| Autor: | Mohammed Ali, Yunji Zhou, Raymond Akawire Aborigo, Haliq Adam, John Koku Awoonor Williams, Raymond Kofi Owusu, John Hembling, Joy Noel Baumgartner, Margaret Lillie, Jessica Mackness, Safiyatu Abubakr-Bibilazu, Eunsoo Timothy Kim, John A. Gallis, Elena McEwan |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
030231 tropical medicine Psychological intervention Ghana law.invention socio-emotional health 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Intervention (counseling) medicine 030212 general & internal medicine Early childhood Depression (differential diagnoses) Interventions General Environmental Science Infant mental health business.industry Mental health Early childhood development Patient Health Questionnaire Original Research Paper Family medicine maternal depression General Earth and Planetary Sciences infant mental health business |
| Zdroj: | Global Mental Health |
| ISSN: | 2054-4251 |
| Popis: | BackgroundCaregiver 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.MethodsThis 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.ResultsIn 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.ConclusionsThis 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. |
| Databáze: | OpenAIRE |
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