The transition to parenthood is often an exciting yet hard period for parents. In the first year after a new baby, many parents feel less confident, have more anxiety and depression, and feel more isolated and alone. During this time, many parents use their phones and the Internet to seek out information and support. Thus, we are exploring the opportunity of using mHealth, or mobile health, to provide information directly to parents after the birth of their first baby. We have developed a program for both birthing and non-birthing parents called the Essential Coaching Postpartum program. This program provides 332 parents with text messages sent for 6 weeks after birth to share information on newborn care and parent outcomes. This will be tailored based on whether they are the birthing parent (Essential Coaching for Every Mother) or non-birthing parent (Essential Coaching for Every Partner). We will evaluate this program by comparing a group of parents who receive the messages to a group of parents do not receive any text messages. To determine the success of the Essential Coaching Postpartum program, we will compare parents' confidence, anxiety, depression, and co-parenting between the two groups after six-weeks and six-months. We believe that parents who get the text messages will have higher confidence and co-parenting outcomes and lower anxiety and depression. Our goal with the Essential Coaching Postpartum program is to help make the first few weeks after a new baby less stressful by providing information and support directly to parents that they know they can trust.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
332
Essential Coaching Postpartum consists of one-way, standardized text messages sent to parents from birth to 6-weeks postpartum to provide evidence-based information on newborn care and mental health. Messages are sent twice a day for the first three weeks (10am and 5pm) and then once a day for the following three weeks (10am), starting the second day after birth.
IWK Health
Halifax, Nova Scotia, Canada
Parenting self-efficacy
Parenting self-efficacy will be measured using the Karitane Parenting Confidence Scale (KPCS) tool. This 15-item tool was developed to assess perceived self-efficacy of parents of infants birth to twelve months of age and has acceptable internal consistent (Cronbach's alpha = 0.81) and test-retest reliability (r = 0.88). A cut off score of 39 or less (out of a possible 45) was determine to be a clinically low perceived parenting self-efficacy (PPSE).
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Postnatal Anxiety
Postnatal anxiety will be measured using the Postpartum Specific Anxiety Scale (PSAS), a 51-item scale that is a valid and reliable measure to assess anxiety during the first six-months postpartum, with individual factor reliability having a Cronbach's alpha from 0.80 to 0.91 with an overall alpha of 0.95. The optimal cut-off PSAS score for detecting clinical levels of anxiety is 112 with a sensitivity and specificity of 0.75.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Postpartum depression
Postpartum depression will be measured using the 10-item Edinburgh Postnatal Depression Scale (EPDS).. A score above 9 (out of 30) indicating a possibility of postpartum depression 30 in both birthing and non-birthing parents.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Postnatal Childcare Stress
Postpartum stress will be measured using the Postpartum Childcare Stress Checklist, an 18-item scale used to measure parental perceptions of childcare stress in the early postpartum period. Responses are summed to produce a score from 0 to 23, where higher scores indicate a higher level of postpartum childcare stress.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
General distress
General distress will be measured using the Depression, Anxiety, and Stress Scale, which is a 21-item scale used to measure the emotional states of depression, anxiety, and stress. High postnatal distress is based on percentile scores, with 0-78 classified as 'normal', 78-87 as 'mild', 87-95 as 'moderate', 95-98 as 'severe', and 98-100 as 'extremely severe'.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Sleep
This will be measured using the PROMIS Short-Form Sleep Related Impairment (4a) and PROMIS Short-Form Sleep Disturbances (4a). Sleep related impairment measures perceptions of alertness, sleepiness, and tiredness during usual waking hours, and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness. On the other hand, sleep disturbance measures perceptions of sleep quality, sleep depth, and restoration associated with sleep. For the v2.0 adult 4-item form, raw scores range from 4-16, with a corresponding T score. Higher scores indicated higher sleep related impairment and disturbance.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Relationship Satisfaction
This will be measured using the Couple Satisfaction Index-4, which is a 4-item scale used to measure one's satisfaction in a relationship. The CSI-4 contains 4 questions: the first item is scored on a 7-point Likert scale with values from 0 ("Extremely Unhappy") to 6 ("Perfect"), the second is scored on a 6-point Likert scale with values from 0 ("Not at all True") to 5 ("Completely True"), and items 3 and 4 are scored on a 6-point Likert scale with values from 0 ("Not at all") to 5 ("Completely"). A total score is calculated by summing the item responses and ranges from 0 to 21; higher scores are associated with higher levels of satisfaction in the relationship. Scores below 13.5 are associated with notable relationship dissatisfaction.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
Co-Parenting
This will be measured using the brief Co-parenting Relationship Scale, which a validated 15-item instrument to assess the five coparenting dimensions of agreement, closeness, child exposure to conflict, coparenting undermining, endorsement of partner's parenting, and labour division.35 Scores range from 0 to 60, with high scores indicating greater coparenting.
Time frame: Enrollment, 6-weeks postpartum, 6-months postpartum
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