See Ling Loy1,2,3, Joyce Teo4, Sze Wern Chan5, Nurul Khairani Abdul Razak5, Oh Moh Chay6,7,8,9, Kee Chong Ng6,4. 1. Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. loy.see.ling@kkh.com.sg. 2. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. loy.see.ling@kkh.com.sg. 3. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore. loy.see.ling@kkh.com.sg. 4. Medical Board, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. 5. Division of Nursing, KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore. 6. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. 7. Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. 8. Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228, Singapore. 9. Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore.
Abstract
BACKGROUND: Enhanced parenting self-efficacy (PSE) contributes to positive parenting and future parental-child health. First-time parents, in particular, are in need of support since the pregnancy until post-delivery to strengthen their early PSE. However, there is a lack of effective and sustainable relevant programmes in the community. The Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) aims to develop a self-learning eco-community throughout the pregnancy and early childhood to promote PSE among first-time parents. We apply choice architecture strategy using behavioural nudges and midwife-led continuity care during the first 1000 days, and test their effects on PSE and mother-child health for first-time families in Singapore. METHODS: This three-arm randomised controlled trial will recruit up to 750 pregnant women from the KK Women's and Children's Hospital, Singapore. Participants will be randomly assigned to receive: (1) standard routine care; (2) behavioural nudges (text messages) along with the use of a social media platform; or (3) midwife-led continuity care involving individualised teleconferencing sessions, during pregnancy and post-delivery. Using web-based questionnaires, participants will be assessed for baseline socio-demography and health status in the first visit, with follow-up assessments in the third trimester, at birth, 6-week (primary end-point), 6-, 12-, 18- and 24-month post-delivery. The primary outcome is PSE. Secondary outcomes include health and birth experience, mental wellness, feeding practice, maternal and child nutritional status. Intention-to-treat and per-protocol analyses will be performed using general linear models to test the effects of interventions across three arms. Recruitment has begun in June 2020 and is estimated to complete in September 2022. DISCUSSION: This study may identify a sustainable effective strategy in the community by helping first-time parents to have a positive experience during the pregnancy, childbirth and parenthood, leading to an enhanced PSE and health outcomes for both mother and child. Findings from this study will provide insight into the implementation of early parenting and mother-child care programmes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04275765 . Registered on 19 February 2020.
RCT Entities:
BACKGROUND: Enhanced parenting self-efficacy (PSE) contributes to positive parenting and future parental-child health. First-time parents, in particular, are in need of support since the pregnancy until post-delivery to strengthen their early PSE. However, there is a lack of effective and sustainable relevant programmes in the community. The Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) aims to develop a self-learning eco-community throughout the pregnancy and early childhood to promote PSE among first-time parents. We apply choice architecture strategy using behavioural nudges and midwife-led continuity care during the first 1000 days, and test their effects on PSE and mother-child health for first-time families in Singapore. METHODS: This three-arm randomised controlled trial will recruit up to 750 pregnant women from the KK Women's and Children's Hospital, Singapore. Participants will be randomly assigned to receive: (1) standard routine care; (2) behavioural nudges (text messages) along with the use of a social media platform; or (3) midwife-led continuity care involving individualised teleconferencing sessions, during pregnancy and post-delivery. Using web-based questionnaires, participants will be assessed for baseline socio-demography and health status in the first visit, with follow-up assessments in the third trimester, at birth, 6-week (primary end-point), 6-, 12-, 18- and 24-month post-delivery. The primary outcome is PSE. Secondary outcomes include health and birth experience, mental wellness, feeding practice, maternal and child nutritional status. Intention-to-treat and per-protocol analyses will be performed using general linear models to test the effects of interventions across three arms. Recruitment has begun in June 2020 and is estimated to complete in September 2022. DISCUSSION: This study may identify a sustainable effective strategy in the community by helping first-time parents to have a positive experience during the pregnancy, childbirth and parenthood, leading to an enhanced PSE and health outcomes for both mother and child. Findings from this study will provide insight into the implementation of early parenting and mother-child care programmes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04275765 . Registered on 19 February 2020.
Authors: Malini Anand Nijagal; Stephanie Wissig; Caleb Stowell; Elizabeth Olson; Isis Amer-Wahlin; Gouke Bonsel; Allyson Brooks; Matthew Coleman; Shamala Devi Karalasingam; James M N Duffy; Tracy Flanagan; Stefan Gebhardt; Meridith E Greene; Floris Groenendaal; J Ravichandran R Jeganathan; Tessa Kowaliw; Marije Lamain-de-Ruiter; Elliott Main; Michelle Owens; Rod Petersen; Irwin Reiss; Carol Sakala; Anna Maria Speciale; Rachel Thompson; Oluwakemi Okunade; Arie Franx Journal: BMC Health Serv Res Date: 2018-12-11 Impact factor: 2.655