None listed
Conditions
Brief summary
Postnatal depression affects around one in ten mothers and can negatively impact the mother–infant relationship, which is critical for healthy child development and mental health. Treatment for maternal depression does not always lead to improvements in this relationship, indicating a need for targeted interventions. eHUGS is an online program adapted from an evidence-based face-to-face intervention, designed to strengthen the mother–infant relationship and support infant mental health. This trial will randomise 126 mothers with infants under 12 months to either the eHUGS program or waitlist control who receive links via SMS to publicly available online parenting resources. Outcomes will be assessed at baseline, post-intervention, and 3-month follow-up. The study will evaluate effects on infant social-emotional development (primary outcome), and secondary outcomes include the mother–infant relationship, perceptions of child temperament and behaviour, parenting self-efficacy, maternal mental health and program satisfaction and usage. It is expected that infants of mothers allocated to eHUGS will show significantly greater improvements in infant social-emotional development at 3 months post-intervention than controls.
Interventions
eHUGS online intervention:
Participants allocated to the intervention will receive access to the eHUGS online program, a primarily self-guided digital intervention with minimal human support. eHUGS is designed to target modifiable aspects of the mother–infant relationship in mothers who have experienced postnatal depression, including maternal communication, observation, responsiveness, and cognitive distortions.
The program consists of four sequential online modules, completed over four weeks
eHUGS online intervention: Participants allocated to the intervention will receive access to the eHUGS online program, a primarily self-guided digital intervention with minimal human support. eHUGS is designed to target modifiable aspects of the mother–infant relationship in mothers who have experienced postnatal depression, including maternal communication, observation, responsiveness, and cognitive distortions. The program consists of four sequential online modules, completed over four weeks (one module per week). Module 1 (Let's Play!) uses guided activities and play to promote connection and enjoyment of parenting. Module 2 (Observing Baby) focuses on observing and responding to infant cues. Module 3 (Your Feelings) explores how past experiences and thoughts and feelings can interfere with parenting and mother-infant interactions. Module 4 (Putting it all together) reinforces key messages for enhancing mother-infant interactions. Each module takes approximately 30 minutes to complete and includes psychoeducation delivered through text and video, as well as guided activities undertaken with the infant, promoting interactions known to strengthen the mother–infant relationship. These activities are play-based and provide a natural context for reestablishing interactions. Participants are encouraged to complete all modules (see below). Modules are released weekly to support progressive skill development. In addition, brief supplementary content related to module topics and program use is available at any time via the eHUGS library (each page requires less than 5 minutes to read). Participants will receive automated SMS messages (10 messages over four weeks; approximately 2–3 per week) to reinforce key content and encourage practice. Following randomisation, participants will receive a single engagement phone call (20–30 minutes) to introduce the eHUGS program, support initial use, and answer any questions. Program usage data will be collected unobtrusively via website analytics and database tracking, including number and duration of logins and modules completed.
Sponsors
Parent-Infant Research Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
1 Days to No maximum
Healthy volunteers
No
Inclusion criteria
a) Women aged >=18 years. b) Infants aged <=12 months. c) Has started or completed treatment or support for postnatal low mood or depression since the birth of their most recent baby (counselling, psychological therapy, support group, medication, or an online program).
Exclusion criteria
a) Women screening positive for low prevalence psychiatric disorders (psychotic or bipolar disorders, substance use). b) Scores >=20 on the Patient Health Questionnaire (PHQ-9) at baseline, indicating extremely severe depression. c) Moderate to high suicide risk at baseline (score >=2 on the Edinburgh Postnatal Depression Scale [EPDS] item 10 or PHQ-9 item 9). d) Significant difficulties with English literacy.
Outcome results
None listed