Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial
Abstract Background Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425121000157/type/journal_article |
| _version_ | 1811156099722641408 |
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| author | Joy Noel Baumgartner Mohammed Ali John A. Gallis Margaret Lillie Raymond Owusu Safiyatu Abubakr-Bibilazu Haliq Adam Raymond Aborigo Elena McEwan Yunji Zhou Eunsoo Timothy Kim Jessica Mackness John Koku Awoonor Williams John Hembling |
| author_facet | Joy Noel Baumgartner Mohammed Ali John A. Gallis Margaret Lillie Raymond Owusu Safiyatu Abubakr-Bibilazu Haliq Adam Raymond Aborigo Elena McEwan Yunji Zhou Eunsoo Timothy Kim Jessica Mackness John Koku Awoonor Williams John Hembling |
| author_sort | Joy Noel Baumgartner |
| collection | DOAJ |
| description | Abstract
Background
Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.
Methods
This cRCT randomized 32 women's groups – 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.
Results
In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.
Conclusions
This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.
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| first_indexed | 2024-04-10T04:44:49Z |
| format | Article |
| id | doaj.art-33365a07095249b598d2f9594e4628c4 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-04-10T04:44:49Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-33365a07095249b598d2f9594e4628c42023-03-09T12:35:44ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512021-01-01810.1017/gmh.2021.15Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trialJoy Noel Baumgartner0https://orcid.org/0000-0002-1783-8972Mohammed Ali1John A. Gallis2Margaret Lillie3https://orcid.org/0000-0002-5246-1795Raymond Owusu4Safiyatu Abubakr-Bibilazu5Haliq Adam6Raymond Aborigo7Elena McEwan8Yunji Zhou9Eunsoo Timothy Kim10Jessica Mackness11John Koku Awoonor Williams12John Hembling13University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC 27516, USA Duke Global Health Institute, Duke University, Durham, NC, USACatholic Relief Services Country Office, Tamale, GhanaDuke Global Health Institute, Duke University, Durham, NC, USA Duke Department of Biostatistics and Bioinformatics, Durham, NC, USADuke Global Health Institute, Duke University, Durham, NC, USACatholic Relief Services Country Office, Tamale, GhanaCatholic Relief Services Country Office, Tamale, GhanaCatholic Relief Services Country Office, Tamale, GhanaNavrongo Health Research Centre, Navrongo, GhanaCatholic Relief Services Head Quarters, Baltimore, MD, USADuke Global Health Institute, Duke University, Durham, NC, USA Duke Department of Biostatistics and Bioinformatics, Durham, NC, USADuke Global Health Institute, Duke University, Durham, NC, USADuke Global Health Institute, Duke University, Durham, NC, USAGhana Health Service, Accra, GhanaCatholic Relief Services Head Quarters, Baltimore, MD, USAAbstract Background Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children. Methods This cRCT randomized 32 women's groups – 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted. Results In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges. Conclusions This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content. https://www.cambridge.org/core/product/identifier/S2054425121000157/type/journal_articleEarly childhood developmentGhanainfant mental healthmaternal depressionsocio-emotional health |
| spellingShingle | Joy Noel Baumgartner Mohammed Ali John A. Gallis Margaret Lillie Raymond Owusu Safiyatu Abubakr-Bibilazu Haliq Adam Raymond Aborigo Elena McEwan Yunji Zhou Eunsoo Timothy Kim Jessica Mackness John Koku Awoonor Williams John Hembling Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial Cambridge Prisms: Global Mental Health Early childhood development Ghana infant mental health maternal depression socio-emotional health |
| title | Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial |
| title_full | Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial |
| title_fullStr | Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial |
| title_full_unstemmed | Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial |
| title_short | Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial |
| title_sort | effect of a lay counselor delivered integrated maternal mental health and early childhood development group based intervention in northern ghana a cluster randomized controlled trial |
| topic | Early childhood development Ghana infant mental health maternal depression socio-emotional health |
| url | https://www.cambridge.org/core/product/identifier/S2054425121000157/type/journal_article |
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