Essential Coaching for Every Mother, a Postpartum Text Message Program for Canadian Mothers

Study Overview
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Brief Summary
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The purpose of this study is to evaluate a text message-based program called Essential Coaching for Every Mother which sends daily text messages during the immediate six-week postnatal period. Essential Coaching for Every Mother consists of standardized text messages that provide evidence-based information that women should be aware of related to caring for their newborn and maternal mental health.

Detailed Description
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This is a 2-group parallel arm randomized controlled trial. Participants will be randomized into either the intervention or a control group, stratified by parity. No changes to in-person care will occur. Mothers in the intervention group will receive daily text messages from enrollment after birth until six-weeks postpartum. Mothers in the control group will receive no content messages. Mothers will be recruited both antenatally and postnatally through social media and study posters. All recruitment and participant engagement will occur remotely via text message. Women who are 37+ weeks pregnant up to 10 days postpartum will be eligible to send a text to a study specific number and complete an eligibility screening. If determined eligible once they deliver, the participant will be randomized into the intervention or control group and they will be asked to complete an electronic consent form and the baseline survey. Participants in the intervention group will start receiving the Essential Coaching for Every Mother program based on their delivery date up to six weeks postpartum. Mothers in the control group will only receive reminder texts to complete the follow-up surveys. Both groups will be asked to complete an online survey at enrolment, six-weeks and six-months postpartum. The investigators aim to recruitment 140 participants in total, 70 per group.

Official Title
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Essential Coaching for Every Mother: A Randomized Controlled Trial Evaluating an Text Message Postpartum Program for Mothers

Conditions
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Maternal Distress

Intervention / Treatment
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* Behavioral: Essential Coaching for Every Mother


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: To enroll antenatally, participants must: be at least 37 weeks pregnant have daily access to a mobile phone with text message capabilities are over 18 years of age speak and read English live in Nova Scotia, Canada. To enroll postnatally, participants must: have an infant under 10 days of age have daily access to a mobile phone with text message capabilities are over 18 years of age speak and read English live in Nova Scotia, Canada. Exclusion Criteria: newborn die or are expected to die prior to leaving the hospital they have no access to mobile phone, either personal or shared unwilling to receive text messages decline or withdraw to participate participated in Phase I of this project.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The current study is a 2-group parallel arm randomized controlled trial, stratified by parity.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Essential Coaching for Every Mother Intervention<br>Women in the intervention arm will receive the Essential Coaching for Every Mother messages up to six-weeks postpartum. No changes in standard care. | Behavioral: Essential Coaching for Every Mother<br>* Essential Coaching for Every Mother consists of 53 standardized text messages that provide evidence-based information that women should be aware of related to caring for their newborn and maternal mental health. Messages are personalized with the name of the child. Messages sent from birth to six-weeks postpartum, with two messages sent per day in the first two weeks and a daily message for weeks 3-6. The following topics covered in Essential Coaching for Every Mother include anxiety, depression, maternal self-care, postnatal follow-up, breastfeeding or formula feeding, infant concerns, cord care, well-baby care, normal development, crying, and safe sleep. Women who receive the messages will be able to self-select breastfeeding or formula feeding messages.<br>|
| No Intervention: Standard care<br>Women in the control group will receive no content messages. No changes in standard care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self Efficacy | Karitane Parenting Confidence Scale (Minimum: 0, Maximum: 45; Higher score indicates greater self-efficacy) | Change from enrolment (baseline) to six-weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Social support | Multidimensional Scale of Perceived Social Support (For the sub-scales of family, friends, and significant other [Minimum: 0, Maximum: 4]; for the total score, [Minimum: 0, Maximum: 12]; higher scores indicate greater support). | Change from enrolment (baseline) to six-weeks | 
| Postpartum anxiety | Postpartum Specific Anxiety Scale (Minimum: 51, Maximum: 204; Higher score indicates higher anxiety) | Change from enrolment (baseline) to six-weeks | 
| Postpartum depression | Edinburgh Postnatal Depression Scale (Minimum: 0, Maximum: 30; Higher score indicates higher depression) | Change from enrolment (baseline) to six-weeks | 
| Self-Efficacy | Karitane Parenting Confidence Scale (Minimum: 0, Maximum: 45; Higher score indicates greater self-efficacy) | Change from six-weeks to six-months postpartum | 
| Social Support | Multidimensional Scale of Perceived Social Support (For the sub-scales of family, friends, and significant other [Minimum: 0, Maximum: 4]; for the total score, [Minimum: 0, Maximum: 12]; higher scores indicate greater support). | Change from six-weeks to six-months postpartum | 
| Postpartum anxiety | Postpartum Specific Anxiety Scale (Minimum: 51, Maximum: 204; Higher score indicates higher anxiety) | Change from six-weeks to six-months postpartum | 
| Postpartum depression | Edinburgh Postnatal Depression Scale (Minimum: 0, Maximum: 30; Higher score indicates higher depression) | Change from six-weeks to six-months postpartum | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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maternal self-efficacy, postpartum depression, postpartum anxiety, mobile health education, postpartum support