The CRADLE (Community-enabled Readiness-for-1000-Days Learning Ecosystem) initiative seeks to improve first-time families' self-efficacy in parenting and to tangibly impact factors in maternal and child care which will result in improved health of mother and child.
Title: CRADLE (Community enabled Readiness for first 1000-Days Learning Ecosystem) Project Introduction: The "developmental origins of health and disease" (DOHaD) is a concept that has emerged over the past 50 years, linking the state of health and risk from disease in early childhood and adult life. With increasing evidence in neuroscience of the critical window of the first 1000 days of life which has life- long impact on cognitive, behavioral, physical and mental health of an individual. In present society where new parents learned the skills from social media which are based on personal perception and not evidence. CRADLE (Community-enabled Readiness-for-1000-Days Learning Ecosystem) initiative seeks to improve first-time families' self-efficacy in parenting and to tangibly impact factors in maternal and child care which will result in improved health of mother and child. Hypothesis: Use of an integrated choice architecture in a self-learning eco-community, with calibrated nudges, and group interactions \& interaction with midwives and individualised teleconferencing sessions in the first 1000-days for first-time families will improve parenting self-efficacy. Method: This will be an Interventional Cohort Study. Each ARM 250 subjects. ARM 1 : Routine care ARM 2 : Behavioral Intervention with nudges and Facebook interaction ARM 3 : Community Intervention with interaction with midwives and individualised teleconferencing sessions The follow up period will be from first contact till child reaches 2 years old Measurement. The investigators will quantify the impact of this initiative through measurements of specific health \& nutrition domains \& patient-reported outcome measures (see below) as well as participant satisfaction. The two key health morbidities the investigators are addressing are the overall health and mental wellness of first-time families as well as their metabolic health (ie, nutrition). 1. Mother's Height and Weight (BMI) 2. Child's Height and Weight (BMI) 3. PROMIS Global-10 Scale 4. Patient Health Questionaire-2 5. Edinburgh Postnatal Depression Scale 6. Parental Sense Of Competency Scale 7. Tool To Measure Parenting Self-Efficacy (TOPSE) 8. Birth Satisfaction Scale 9. Breastfeeding Self-Efficacy Scale 10. Infant Feeding Questionnaire
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
750
Participants will receive nudges and be enrolled to Facebook group for self-learning.
Participants will receive individualised teleconferencing sessions and phone calls by skilled midwives.
KK Women's and Children's Hospital
Singapore, Singapore
RECRUITINGParenting self-efficacy
Parenting self-efficacy as assessed by the Tool to measure Parenting Self-Efficacy, which is domain-specific.
Time frame: Up to 24 months of age, from 6 weeks after birth until 24 months of age
Parenting self-efficacy
Parenting self-efficacy as assessed by the Parental Sense of Competence Scale, which is domain-general.
Time frame: Up to 24 months of age, from 6 weeks after birth until 24 months of age
Health experience
Health Experience as assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global10.
Time frame: Up to 18 months of age, from first trimester in pregnancy until 18 months during the postnatal period
Birth experience
Birth Experience as assessed by the Birth Satisfaction Scale - Revised.
Time frame: At point of birth
Mental wellness
Mental wellness as assessed by the Patient Health Questionnaire-2.
Time frame: Up to 6 months of age, from first trimester in pregnancy up to 6 months during postnatal period
Depressive symptoms
Depressive symptoms as assessed by the Edinburg Postnatal Depression Scale (EPDS).
Time frame: Up to 6 months of age, from first trimester in pregnancy up to 6 months during postnatal period
Maternal nutritional status
Maternal nutritional status as assessed based on weight status, i.e. weight gain and weight retention.
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Time frame: Through study completion, from first trimester in pregnancy up to 24 months during postnatal period
Child nutritional status
Child nutritional status as assessed based on weight and height.
Time frame: From birth until up to 24 months during postnatal period
Breastfeeding self-efficacy
Breastfeeding self-efficacy as assessed by the Breastfeeding Self-Efficacy Score-Short Form.
Time frame: From birth until up to 6 months during postnatal period
Maternal feeding beliefs and practices
Maternal feeding beliefs and practices as assessed by the Infant Feeding Questionnaire.
Time frame: At 18 months of age, at 18 months during postnatal period