Feasibility and acceptability of an early home visit intervention aimed at supporting a positive mother-infant relationship for mothers at risk of postpartum depression

Abstract

Aims: Perinatal depression is associated with difficulties in the early mother-child interaction and negative child outcome. The aim of this study was to assess the feasibility and acceptability of the Newborn Behavioral Observation (NBO) System included in a home visiting programme at well-baby clinics in Norway and to examine compliance with the study protocol for a future clinical trial. The target group was pregnant women at risk for postpartum depression and their partners.

Method: An open-label study was conducted. A total of 15 pregnant women and 10 partners were recruited during 24-28 weeks of gestation. The NBO was conducted in three home visits during the first four weeks after birth. Data were collected from surveys responded to by parents and healthcare workers at six time-points and from video recordings of mother-infant interaction by the Emotional Availability (EA) Scale. The parents' experience of the intervention and data collection was investigated by qualitative analyses of five interviews. The NBO is an individualised, relationship-based method aimed to strengthen the emotional bond between the parents and their infants and enhance the parents' alliance with the healthcare worker.

Results: Intervention completion was 97%. Data collection completion was 100% at baseline and the second time-point and dropped to 50% for the mothers and 40% for the fathers at the sixth time-point. However, 79% (11 of 14) of the mothers and infants took part in video recordings for the EA coding at 4 months postpartum (sixth time-point). The usefulness questionnaires showed high acceptability among both parents and healthcare workers.

Conclusion: This study showed that the NBO conducted in home visits is a feasible and acceptable intervention for both parents and healthcare workers within the well-baby clinic services. A future clinical trial protocol needs adjustments related to data collection.

Keywords: Newborn Behavioral Observation; acceptability; early intervention; emotional availability; feasibility; infant-mother interaction; postpartum depression.