Parents Clinical Trial
Official title:
Antenatal Preparation for Early Parenthood: A Pilot Study of a Cluster Randomised Controlled Trial Evaluating a New Programme Based on First-time Parents' Preferences
Becoming a parent is a challenging stage in life, which provokes feelings of both excitement
and insecurity; parents strive to develop confidence in their parenting role. Studies show
that new parents often feel inadequately prepared for early parenthood which may have a
negative impact on adjustment to life as a parent as well as health and wellbeing for the
whole family.
The overall aim is to develop, pilot test and evaluate a new programme for antenatal
preparation for the early parenthood period. The hypothesis is that expectant first-time
parents who receive an intervention with a new programme for antenatal preparation for
parenthood will show higher scores for parental self-efficacy in the early parenthood period
than those who do not receive the intervention. The specific aims for the pilot study are:
1. To assess the acceptability of the procedures for parents and providers (midwives)
2. To estimate the likely rates of recruitment and retention of participants
3. To estimate the effects on outcome measurements in order to calculate the appropriate
sample size in a full scale randomized controlled trial (RCT).
Antenatal clinics will be randomised to either intervention group, and provide a new
programme of antenatal parental preparation, or to control group and provide a regular
programme of antenatal parental preparation. First-time expectant parents will be invited in
early pregnancy by the midwives at the antenatal clinics to participate in the study by
partaking in an evaluation of the different ways to provide antenatal parental preparation.
Parents who agree to participate will receive postal questionnaires before the antenatal
parental preparation start and approximately four weeks after giving birth.
Midwives working in antenatal clinics randomised to the intervention group will receive a
one-day-education before providing the intervention antenatal parental preparation. These
midwives will also receive questionnaires, after the education and after providing the
antenatal parental preparation.
All midwives, in both control group and intervention group, providing antenatal parental
preparation will be given a form with questions related to the content in the provided
programme to fill in.
Development of the intervention; The development of the intervention was guided by the
Medical Research Council's (MRC) framework for development and evaluation of complex
interventions. The development phase involves identifying the evidence base, identifying or
developing theory and modelling process and outcome. Based on reviews of literature and the
results of previous studies in this project, the concept of self-efficacy in Social Cognitive
Theory was identified as a suitable theory in the development and evaluation of the
intervention.
Details of recruitment and randomisation of Antenatal clinics; Antenatal clinics (ANCs),
which offer the most common model (regular) for antenatal parental preparation, as mapped out
in a previous study, will be invited to participate in the pilot study which will compare the
regular programme for antenatal parental preparation (control group) with a new programme for
antenatal parental preparation (intervention group). Cluster randomisation of ANCs will be
used to minimise contamination between the different programmes of antenatal preparation in
the two groups. Randomisation will be stratified according to Care Need Index (CNI) which is
based on socio-demographic variables of expectant mothers registered with the participating
ANCs. A mean value of the CNIs of participating ANCs will be calculated, those below the mean
value will form one strata and those above the mean value will form the other strata. Half of
the ANCs will be randomised to the intervention group and half to the control group.
Details of preparations to provide the new programme intervention; A full-day education will
be provided for midwives at the ANCs randomised to the intervention group which will include
group leadership skills to facilitate peer learning among parents, evidence-based websites,
framework for co-parenting and details regarding the new programme. The education to the
midwives will be followed up with personal phone contact 1-2 months after the education, by
the educator, in order to give opportunities for questions and clarifications in order to
provide the intervention programme.
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