The “Look! - your baby is talking to you” intervention study aiming to reduce post-partum depressive symptoms among vulnerable mothers: A process evaluation.

Abstract Background : A successful early parent-infant interaction may be threatened by maternal anxiety or depression. The obstetric department's healthcare professionals are in a unique position to initiate early intervention. Early interventions and short-term programmes aiming to improve mother-infant interaction have shown to be successful. This study aimed to evaluate the intervention study “Look! – Your baby is talking to you” with the primary aim of lowering maternal postnatal depression symptoms three months after birth. The intervention adopted a relationship-based approach in a family-oriented context and aimed to optimise transition to primary healthcare for vulnerable families. The intervention components included the Newborn Behavioral Observations System, family-focused nursing, and a systematic transition to primary healthcare. Methods : By examining implementation, i.e., reach, dose, fidelity, and mechanisms of impact of the intervention "Look! – Your baby is talking to you", we evaluated the intervention study using the UK Medical Research Council process evaluation framework. The contextual considerations and adaptations made to ensure implementation were in focus of the evaluation. Results : The intervention “Look! – your baby is talking to you” reached the intended target group of vulnerable mothers with previous or current depression and/or anxiety. In the intervention group, 47 women completed the follow-up questionnaires; in the non- intervention group, 51 women responded to the questionnaires. The intervention dose was delivered as intended with high fidelity, proving that the healthcare professionals increased knowledge, intention, skills, and self-efficacy in relation to postnatal care after Newborn behavioural observation training. Mechanisms of impact reflected mixed effect results. However, both the primary (maternal depressive symptoms) and the secondary outcomes (maternal stress, reflective function, and family function) tended to favour the intervention group. Conclusion : Overall, the intervention was applicable to clinical practice. It was feasible and had high participation. Furthermore, the process evaluation revealed potential facilitators and barriers to the targeted processes, which is essential knowledge for future evaluation of the effects of the intervention. Trial registration: ClinicalTrials.gov ID: NCT04169334, Registered 19 November 2019.