JMIR Publications

ABSTRACT

Background:

Transition to parenthood can be stressful to new parents in Singapore, especially with the lack of continuity of care from healthcare professionals during the postpartum period. Short hospital stays limit the availability of support and time parents need to be well-equipped with parenting and infant care skills. Poor parental adjustment may in turn lead to negative parental outcomes and adversely affect the child’s development. Therefore, for the family’s future wellbeing and in order to facilitate smoother transition to parenthood, there is a need for easily accessible technology-based educational programs that can support parents during this crucial perinatal period.

Objective:

To examine the effectiveness of a technology-based supportive educational parenting program (SEPP) on parenting outcomes during the perinatal period.

Methods:

A randomized controlled pretest-posttest experimental study design was used. The study recruited 236 patients (118 couples) from an antenatal ward of a tertiary hospital. Eligible parents were randomly assigned to the intervention group (n = 118) or the control group (n = 118). The SEPP is based on Bandura’s self-efficacy theory and Bowlby’s theory of attachment. Components of the intervention include two telephone-based education sessions and a mobile-health application follow-up for one month. Outcome measures including parental bonding, parental self-efficacy, perceived social support, parenting satisfaction, postnatal depression, and anxiety were measured using reliable and valid instruments. Data were collected over 12 months (December 2016 to December 2017) at four timepoints: during pregnancy (third trimester), immediately postpartum, one month postpartum, and three months postpartum. A linear mixed methods analysis was used to compare the percentage change of all outcome variables.

Results:

The intervention group had statistically significant improvements for parental bonding [P < 0.001, 95%CI -4.78 – -3.90], parental self-efficacy [P < 0.001, 95% CI: 1.94 – 2.79], social support [P < 0.001, 95% CI: 2.78 – 3.47], parenting satisfaction [P < 0.001, 95% CI: 3.14 – 3.83], postnatal depression [P < 0.001, 95% CI: -3.93 – -3.15], and postnatal anxiety [P < 0.001, 95% CI: -3.65 – -2.85] at one month and three months postpartum compared to the control group. A cessation of the intervention at one month postpartum showed a decline in all parental outcomes.

Conclusions:

The technology-based SEPP is effective in improving parental bonding, parental self-efficacy, perceived social support, parental satisfaction, and parental bonding. Hence, nurses and midwives should incorporate it with existing hands-on parent-craft classes and routine care. Further studies should investigate the long-term effectiveness (beyond three months) of this program on parental outcomes. Clinical Trial: ISRCTN48536064