'Becoming parents' : a hospital-community partnership to enhance transition to parenthood

In reality, couples face many challenges in the transition to parenthood. These challenges can hardly be imagined and are always beyond the couple expectations. In the transition process, three common difficulties that new parents encounter are postnatal depression, the decline of marital relationships and inadequate parenting competence. This study aimed to implement and evaluate the ‘Becoming Parents’ programme for a cohort of Chinese new parents using a cluster randomized controlled trial. 138 couples were recruited to the intervention group and 150 couples to the control group. The attrition rate in intervention and control groups was around 12.3% and 3-4%, respectively, by three months post-delivery. Couples in the intervention group were invited to join the ‘Becoming Parents’ programme that consisted of two phases. Phase one consisted of three antenatal sessions which focused on enhancing their communication skills and baby caring skills. Phase two provided social support to new parents from trained volunteers for up to three months post-delivery. The mixed linear analysis method with the intention-to-treat principle was used to evaluate the intervention effects. The couples’ postnatal depressive symptoms, marital satisfaction and parenting competence scores at three time-points, 20-24 weeks of gestation, 30-34 weeks of gestation and three months post-delivery, were collected and analyzed. After three months post-delivery, there were no intervention effects on minimizing postnatal depressive symptoms in the women (mean difference -7.51, CI -1.49 to 0.01, p=0.48) and men’s groups (mean difference -0.32, CI -0.65 to 0.58, p=0.91). There was no effect on sustaining marital satisfaction in the women’s group (mean difference 0.39, CI -1.99 to 2.77 p=0.74); however a mild effect was noted in the men’s group (mean difference -0.65 CI, -2.97 to 1.66, p=0.57) but it was not significant. There was no effect on parenting competence among either women (mean difference 1.1, CI -0.37 to 2.58, p=0.14) or men’s groups (mean difference 0.05, CI -1.42 to 1.54, p=0.93), although no significant was noted. In addition, the study found that women with no family support had a higher mean depression score (6.0, CI 1.64-10.35, p>0.5) than women cared for by four people (0.5, CI -3.86 to 4.86, p>0.5). Moreover, the mean depression score of women who were taken care of by their mothers-in-law (4.16, CI 3.44 to 4.87) was higher than those taken care by their own mothers (2.71, CI 2.15 to 3.26). In general, the couples welcomed support from volunteers. The factors affecting the intervention may be related to the difference in the women’s employment status and the social support they received, as more women in the control group were housewives and all of them had supported by at least one caregiver in the postnatal period. However, not all women in the intervention group received social support, and the number of women supported by their mothers-in-law was higher in that group. This is the first programme to adopt non-professional mother-volunteers to support new mothers and fathers together. Both new parents and volunteers had positive perceptions towards the programme and also expressed that the project was beneficial to them.published_or_final_versionNursing StudiesDoctoralDoctor of Nursin