Maternal psychosocial health and wellbeing Mental and Behavioural Disorders
Conditions
Interventions
Women leaders known to the PI requested a group intervention that could help women in their communities. Local leaders steered group processes. The participatory research approach involved initial ne
developed a theory of change
mapped community needs, resources, and stakeholders
and pilot-tested group methodologies. Individual and group activities drew from a broad range of evidence-based and local approaches including cognitive behavioural therapy (CBT) (emotional self-manag
Sponsors
Instituto de Nutricion de Centro America
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Pregnant or under two years postpartum 2. At least one of the following conditions: socioeconomic disadvantage, domestic violence, difficult interpersonal relationships, poor social support, psychological distress. These criteria were based on known risk factors, circle leaders’ assessment of what constituted maternal vulnerability, and prior research in nearby Mam communities
Exclusion criteria
Exclusion criteria: 1. Women who were not from study communities 2. Not within the first 1,000 days (pregnancy to 2 years postpartum) 3. Failed to provide consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| A questionnaire assessed the following four measures of psychosocial health and functioning (primary outcomes) at baseline and at one-month post-intervention: 1. Maternal symptoms of depression and anxiety over the last month, measured using the Hopkins Symptom Checklist-25 (HSCL-25), a symptom inventory composed of a 10-item anxiety cluster, a 13-item depression cluster, and two additional somatic symptoms. Each item scores on a scale from one (not at all) to 4 (extremely); item scores can be summed to provide an estimate of the severity of anxiety and depression symptomatologies. A higher score indicates greater distress 2. Maternal wellbeing, measured using the Mental Health Continuum Short Form (MHC-SF), comprised of 14 items representing the three dimensions of wellbeing: emotional, social and psychological. Each item scores on a scale from zero (never) to four (always), based on experiences in the previous month, allowing for continuous assessment of positive mental health. A higher score indicates greater wellbeing 3. Self-efficacy, measured using a four-item subscale measuring self-efficacy in childcare (feeding, caring and cleaning, playing and talking, helping recover from illness) and a four-item subscale measuring self-efficacy in self-care (overcoming daily problems; staying calm when worried, nervous, or afraid; finding reliable people for support; dedicating time to herself). Each item scores on a scale from zero (I can’t do it) to three (I can do it), allowing for continuous assessment of childcare self-efficacy, self-care self-efficacy, and total self-efficacy. A higher score indicates greater self-efficacy 4. Mother’s engagement in early infant stimulation, measured using six items from the UNICEF Multiple Indicator Cluster Survey Early Child Development module capturing adult-child interactions, assessing whether mothers engaged with her infant in six different activities (e.g., readi | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Acceptability was assessed in post-intervention focus groups and in-depth interviews, when participants were asked whether they were satisfied with the intervention, would recommend it to other women, and would have preferred it to be any different. Participants were also asked to report on their (or other women’s) barriers to participation; circle leaders were asked what strategies they used to overcome these 2. Intervention feasibility was assessed during post-intervention focus groups and in-depth interviews. Circle leaders were asked whether they felt comfortable in their ability to lead the Women's Circles, had received enough training and support, felt that implementation logistics were appropriate (i.e. session frequency, location and length, materials, compensation), and what they might change. Objective data included: rate of circle leader retention, rate of women participant retention, and number of sessions attended | — |
Countries
Guatemala
Outcome results
None listed