The SMART app is a mobile application based psychosocial parenting intervention containing educational materials (articles, videos, audios, podcasts) on parenting, an integrated peer support chat function with experienced mothers and an integrated forum for interaction with other mother participants. The goal of this interventional study is to test the effectiveness of a mobile-app health based intervention, SMART, mothers in the perinatal period. The main questions this study aims to answer are: 1. What is the effect of a mobile-based health intervention, SMART, on maternal outcomes? 2. What is the effect of a mobile-based health intervention, SMART, on infant outcomes? 3. What is the cost-effectiveness of using SMART as compared to standard routine care? Researchers will compare results with a control group that will undergo standard routine care.
This project aims to develop and evaluate a mobile-health application based Supporting at-risk Mothers across perinatal period: A Randomized controlled Trial (SMART) intervention on maternal outcomes such as maternal depression, anxiety and stress, parenting self-efficacy, help-seeking behaviour and attachment and interaction levels , newborn outcomes such as physical, social and emotional development as well as the cost-effectiveness of the intervention. When compared with those in the control group receiving standard care: 1. mothers receiving SMART intervention will have better: i) emotional well-being (reduced depression, stress, and anxiety); ii) parenting self-efficacy; iii) social support; and iv) attachment, interactions with their newborns and parenting satisfaction. 2. newborns of mothers receiving SMART will have better: i) physical development; ii) social development; and iii) emotional development. 3. It will be more cost-effective to provide SMART than the standard care. A randomized controlled, two-group pre-test and repeated post-tests, experimental design will be used. Mothers will be randomly assigned to the intervention group, where they will receive the SMART intervention (Access to the mobile App from pregnancy till 6 months postpartum) which includes knowledge-based content with audio and video materials, a peer discussion forum with other mothers, online chat groups with peer volunteer who are experienced mothers plus the standard care. Peer volunteers will be recruited and their role is to provide support to the mother via a weekly chat with the mothers through the SMART application. The control group will receive the standard care provided by the hospitals and polyclinics. The effectiveness of SMART intervention will be measured based on the improvement of maternal depression (primary outcome), stress and anxiety, parenting self-efficacy in newborn care, social support received by mothers, mother-infant attachment, and interactions as well as newborn outcomes including physical, behavioral (social) and emotional development. Newborn data such as baby gender, order of birth, baby weight and developmental milestones will be collected to examine their development.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
200
The intervention is delivered through the SMART mobile application. It contains educational information in audio, visual, article format; on parenting, pregnancy and managing emotional well-being. There is also a peer support feature where participants can speak to experienced mothers via the SMART app. There is also a forum feature where participants can interact with other mothers.
Alice Lee Centre for Nursing Studies, National University of Singapore
Singapore, Singapore
RECRUITINGNational University of Singapore
Singapore, Singapore
RECRUITINGPostnatal depression
Measured via the Edinburgh Postnatal Depression Scale, a 10-item self-reported questionnaire based on a 4-point Likert scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Infant physical development
Measured via the Bayley Scale-4th edition
Time frame: 1 month and 6 month at immediate post intervention
Infant cognitive development
Measured via the Bayley Scale-4th edition
Time frame: 1 month and 6 month at immediate post intervention
Infant emotional development
Measured via the Bayley Scale-4th edition
Time frame: 1 month and 6 month at immediate post intervention
Anxiety
Measured via the State Trait Anxiety Inventory (STAI), a 40-item self-reported questionnaire based on a 4-point Likert scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Perceived stress
Measured via the Perceived Stress Scale-10 (PSS-10), a 10-item self-reported questionnaire on a 5 point Likert scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Perceived social support
Measured via the Perceived Social Support for Parenting (PSSP), a 10-item questionnaire on a 5-point Liker scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Maternal-infant bonding
Measured via the Maternal-Infant Bonding Scale (MIBS), an 8-item self-reported questionnaire on a 4-point Likert scale
Time frame: 1 month, 6 month, 9 month and 12 month post childbirth
Parental satisfaction
Measured via the What Being the Parent of A Baby is Like (WPL), an 11-item self-reported questionnaire on a 9-point Likert scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Parental efficacy
Measured via a 10-item questionnaire on a 4-point Likert scale
Time frame: Baseline and 6 month, 9month, 12month post childbirth
Objective stress
Measured via salivary cortisol biomarkers obtained through saliva samples
Time frame: 1 month and 6 month at immediate post intervention
Emotional availability
Measured through the Emotional Availability Scale (EAS), a 5-dimension framework assessing both the parent and the infant via an observer.
Time frame: 1 month and 6 month at immediate post intervention
Health services and utilization
Measured on the Questionnaire on health services and utilization (QHSU)
Time frame: Baseline, 1 month, 6 month and 12month post childbirth
Infant Physical Development
Measured by the Ages and Stages Questionnaire-3
Time frame: 1 month, 6 month, 9 month and 12 month post childbirth
Infant Social Development
Measured by the Ages and Stages Questionnaire-3
Time frame: 1 month, 6 month, 9 month, 12 month post childbirth
Infant Social Development
Measured by the Brief-Infant and Toddle Social and Emotional Assessment (B-ITSEA)
Time frame: 12 month post childbirth
Infant Social Development
Measured by the Bayley Scale-4th edition
Time frame: 1 month and 6 month at immediate post intervention
Infant Emotional Development
Measured by the Brief Infant Toddler Social Emotional Assessment (B-ITSEA)
Time frame: 12 month post childbirth
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