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Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial

Fisher, Jane, Rowe, Heather, Wynter, Karen, Tran, Thach, Lorgelly, Paula, Amir, Lisa H., Proimos, Jenny, Ranasinha, Sanjeeva, Hiscock, Harriet, Bayer, Jordana and Cann, Warren 2016, Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial, BMJ open, vol. 6, no. 3, doi: 10.1136/bmjopen-2015-009396.

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Title Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial
Author(s) Fisher, Jane
Rowe, Heather
Wynter, KarenORCID iD for Wynter, Karen orcid.org/0000-0003-4620-7691
Tran, Thach
Lorgelly, Paula
Amir, Lisa H.
Proimos, Jenny
Ranasinha, Sanjeeva
Hiscock, Harriet
Bayer, Jordana
Cann, Warren
Journal name BMJ open
Volume number 6
Issue number 3
Total pages 18
Publisher BMJ Publishing
Place of publication London, Eng.
Publication date 2016-03-07
ISSN 2044-6055
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
postnatal common mental disorders
prevention
psychoeducation
father-inclusive
PRIMARY CARE
INFANT SLEEP
REDUCE DEPRESSION
PRIMARY-CARE
RISK-FACTORS
HEALTH
ANXIETY
SUPPORT
BIRTH
CHILDBIRTH
BEHAVIOR
Summary Objectives: Interventions to prevent postpartum common mental disorders (PCMD) among unselected populations of women have had limited success. The aim was to determine whether What Were We Thinking (WWWT) a gender-informed, psychoeducational programme for couples and babies can prevent PCMD among primiparous women 6 months postpartum. Design: Cluster-randomised controlled trial. Setting: 48 Maternal and Child Health Centres (MCHCs) from 6 Local Government Areas in Melbourne, Australia were allocated randomly to usual care (24) or usual care plus WWWT (24). Participants: English-speaking primiparous women receiving primary care at trial MCHCs were recruited to the intervention (204) and control (196) conditions. Of these, 187 (91.7%) and 177 (90.3%) provided complete data. Intervention: WWWT is a manualised programme comprising primary care from a trained nurse, print materials and a face-to-face seminar. Main outcome measures: Data sources were standardised and study-specific measures collected in blinded computer-assisted telephone interviews at 6 and 26 weeks postpartum. The primary outcome was PCMD assessed by Composite International Diagnostic Interviews and Patient Health Questionnaire (PHQ) Depression and Generalised Anxiety Disorder modules. Results: In intention-to-treat analyses the adjusted OR (AOR) of PCMD in the intervention compared to the usual care group was 0.78 (95% CI 0.38 to 1.63, ns), but mild to moderate anxiety symptoms (AOR 0.58, 95% CI 0.35 to 0.97) and poor self-rated health (AOR 0.46, 95% CI 0.22 to 0.97) were significantly lower. In a per protocol analysis, comparing the full (three component) intervention and usual care groups, the AOR of PCMD was 0.36, (95% CI 0.14 to 0.95). The WWWT seminar was appraised as salient, comprehensible and useful by >85% participants. No harms were detected. Conclusions: WWWT is readily integrated into primary care, enables inclusion of fathers and addresses modifiable risks for PCMD directly. The full intervention appears a promising programme for preventing PCMD, optimising family functioning, and as the first component of a stepped approach to mental healthcare.
Language eng
DOI 10.1136/bmjopen-2015-009396
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2016, The Authors
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30129874

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.