OBJECTIVES: To establish whether providing additional postnatal support during the early postnatal months influences women's physical and psychological health and to identify health service benefits. DESIGN: Pragmatic randomised controlled trial with a 2 x 2 factorial design with two interventions. SETTING: Community centres, Ayrshire and Grampian, Scotland. POPULATION: One thousand and four primiparous women, 83% completed the baseline questionnaire, 71% at six months. METHODS: (1) An invitation to a local postnatal support group run weekly with a facilitator, starting two weeks postpartum. (2) A postnatal support manual, posted two weeks postpartum. MAIN OUTCOME MEASURES: Data regarding primary outcome postnatal depression (Edinburgh Postnatal Depression Scale, EPDS), secondary outcomes, general health measures (SF-36), social support (SSQ6), use of health services and women's views of interventions were collected at two weeks postpartum and at three and six months. RESULTS: There were no significant differences in EPDS scores between the control and trial arms at three and six months, nor were there differences in the SF-36 and the SSQ6 scores. The 95% CI for the difference in EPDS effectively excluded a change in mean score of more than 10% with either intervention. There were no differences in health service attendances in primary or secondary care between the control and trial arms. Of those women who attended the groups, 40% attended six or more. Women reported favourably on the 'pack' with the majority reading it a few times and feeling that it was aimed at them. CONCLUSIONS: Wide-scale provision by the National Health Service of either support groups or self-help manuals is not appropriate if the aim is to improve measurable health outcomes.
RCT Entities:
OBJECTIVES: To establish whether providing additional postnatal support during the early postnatal months influences women's physical and psychological health and to identify health service benefits. DESIGN: Pragmatic randomised controlled trial with a 2 x 2 factorial design with two interventions. SETTING: Community centres, Ayrshire and Grampian, Scotland. POPULATION: One thousand and four primiparous women, 83% completed the baseline questionnaire, 71% at six months. METHODS: (1) An invitation to a local postnatal support group run weekly with a facilitator, starting two weeks postpartum. (2) A postnatal support manual, posted two weeks postpartum. MAIN OUTCOME MEASURES: Data regarding primary outcome postnatal depression (Edinburgh Postnatal Depression Scale, EPDS), secondary outcomes, general health measures (SF-36), social support (SSQ6), use of health services and women's views of interventions were collected at two weeks postpartum and at three and six months. RESULTS: There were no significant differences in EPDS scores between the control and trial arms at three and six months, nor were there differences in the SF-36 and the SSQ6 scores. The 95% CI for the difference in EPDS effectively excluded a change in mean score of more than 10% with either intervention. There were no differences in health service attendances in primary or secondary care between the control and trial arms. Of those women who attended the groups, 40% attended six or more. Women reported favourably on the 'pack' with the majority reading it a few times and feeling that it was aimed at them. CONCLUSIONS: Wide-scale provision by the National Health Service of either support groups or self-help manuals is not appropriate if the aim is to improve measurable health outcomes.
Authors: M Wiggins; A Oakley; I Roberts; H Turner; L Rajan; H Austerberry; R Mujica; M Mugford; M Barker Journal: J Epidemiol Community Health Date: 2005-04 Impact factor: 3.710
Authors: Beth A Lewis; Dwenda K Gjerdingen; Melissa D Avery; Hongfei Guo; John R Sirard; Amanda R Bonikowske; Bess H Marcus Journal: Contemp Clin Trials Date: 2012-08-05 Impact factor: 2.226
Authors: Elizabeth Werner; Maia Miller; Lauren M Osborne; Sierra Kuzava; Catherine Monk Journal: Arch Womens Ment Health Date: 2014-11-25 Impact factor: 3.633