The Effect of a Father Inclusive Psychoeducation Program on Postnatal Depression: a Randomized Controlled Trial
Phase: NA
Conditions: Pregnancy
Sponsor: The University of Hong Kong

	  
1  
Title:  The  Effect  of  a  Father  Inclusive  Psychoeducation  Program  on  Postnatal  Depression:  a  
Randomized  Controlled  Trial  
Investigators  
Fei  Wan  Ngai,  School  of  Nursing,  The  Hong  Kong  Polytechnic  University  
Paul  Wai-­Ching  Wong,  Department  of  Social  Work  and  Social  Administration,  The  University  of  Hong  
Kong  
Pui-­Hing  Chau,  School  of  Nursing,  The  University  of  Hong  Kong  
Ka-­Fai  Chung,  Department  of  Psychiatry,  The  University  of  Hong  Kong  
Background  
Having  a  first  child  is  a  key  marker  of  the  transition  into  parenthood  that  requires  substantial  
adjustment  of  couples'  life.  A  recent  meta-­analysis  published  in  the  Journal  of  American  Medical  
Association  reports  that  both  women  (23.8%)  and  men  (10.4%)  suffer  from  perinatal  depression  [1].  
The  father's  involvement  during  pregnancy  can  positively  influence  health  outcomes  not  only  for  the  
man,  but  his  partner,  and  their  children  [1,2].  However,  the  effectiveness  of  father's  involvement  in  
prenatal  care  in  preventing  paternal  and  maternal  depression,  is  still  unknown.  
  
  

	  
2  
Aims  
This  study  seeks  to:  (1)  evaluate  the  effect  of  a  father  inclusive  psychoeducation  program  for  first-­time  
Chinese  mothers  and  fathers  on  depressive  symptoms  (primary  outcome),  marital  relationships  and  
quality  of  life  at  6  weeks,  6  months  and  one  year  postpartum;;  and  (2)  explore  fathers'  involvement,  
their  perceived  benefits  of  participating  in  the  program  and  factors  influencing  the  effectiveness  of  the  
program.  
Methods  
This  study  employs  a  longitudinal,  randomized,  pre  and  post-­test  design.  A  convenience  sample  of  
576  couples  will  be  recruited  at  antenatal  clinics  and  randomly  assigned  to  one  of  three  groups:  (1)  the  
experimental  group  with  both  couples  receives  the  intervention  on  top  of  usual  perinatal  care;;  (2)  the  
comparison  group  with  only  the  women  receives  the  intervention  on  top  of  usual  perinatal  care;;  and  
(3)  the  control  group  receives  usual  perinatal  care  only.  The  intervention  consists  of  a  single  3-­hour  
session  during  pregnancy  and  two  telephone  follow-­up  at  postpartum  week  one  and  week  two.  
Primary  outcome  on  postnatal  depression  will  be  assessed  by  Edinburgh  Postnatal  Depression  Scale.  
Secondary  outcomes  on  marital  relationship  and  quality  of  life  will  be  assessed  by  Dyadic  Adjustment  
Scale  and  Medical  Outcomes  Study  Short  Form  12-­item  Health  Survey,  respectively,  at  baseline,  6  
weeks,  6  months  and  one  year  postpartum.  Process  evaluation  will  be  conducted  at  6  weeks  

	  
3  
postpartum  using  individual  telephone  interview  on  20  couples  randomly  selected  from  the  
experimental  group.  
Data  Analysis  
Data  analyses  will  be  conducted  using  the  Statistical  Package  for  the  Social  Sciences  (SPSS)  for  
Windows.  Intention  to  treat  principle  will  be  used.  Descriptive  statistics  will  be  used  to  summarize  the  
data,  such  as  demographics  and  outcome  variables.  Homogeneity  among  the  study  groups  on  the  
demographics  and  baseline  variables  will  be  assessed  using  one-­way  analysis  of  variance  (ANOVA)  
and  chi-­square  test.  A  repeated-­measures  multivariate  analysis  of  variance  (MANOVA)  will  be  
performed  separately  for  the  two  gender  to  test  for  significant  differences  among  the  three  groups  on  
the  outcome  variables  including  depressive  symptoms,  marital  relationship,  and  quality  of  life  at  
baseline,  6  weeks,  6  months  and  one  year  postpartum;;  and  post-­hoc  comparisons  for  between  groups  
differences.  Interview  data  will  be  analyzed  by  content  analysis.  
  
  

	  
4  
References  
1.   Paulson,  J.F.,  &  Bazemore,  S.D.  (2010).  Prenatal  and  postpartum  depression  in  fathers  and  its  
association  with  maternal  depression:  A  meta-­analysis.  Journal  of  American  Medical  Association,  
303,  1961-­1969.  
2.   Ramchandani,  P.G.,  Psychogiou,  L.,  Vlachos,  H.,  Iles,  J.,  Sethna,  V.,  Netsi,  E.,  &  Lodder,  A.  
(2011).  Paternal  depression:  An  examination  of  its  links  with  father,  child  and  family  functioning  in  
the  postnatal  period.  Depression  and  Anxiety,  28,  471-­477.