Wilson, Holly; (2021) The accessibility and acceptability of a brief “IPT-informed” intervention for pregnant first-time mothers in the context of the COVID-19 pandemic. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Introduction: This thesis project trialled a brief “IPT-informed” intervention with pregnant first-time mothers during the COVID-19 pandemic. Aims: The aims of the brief “IPT-informed” intervention were to 1) educate participants as to the symptoms of ‘baby blues’ and PND 2) provide participants with a brief overview of IPT as an intervention and the theoretical concepts underpinning it 3) help participants map out their social network through using the ‘interpersonal inventory’ 4) assist participants in anticipating the transitions to motherhood. The research questions were 1) Is this brief group intervention accessible and acceptable for expectant and new mothers? 2) Does this brief group intervention have any adverse effects for expectant and new mothers? 3) Could this trial provide evidence for a larger ‘preventative’ trial in the future? Method: The design of the study was a mixed-methods, uncontrolled, longitudinal feasibility study. Twelve first-time mothers who were 6+ months pregnant took part in a brief “IPT-informed” group intervention prior to birth. All twelve mothers also took part in an individual follow-up session and brief semi-structured interview around two to three months after birth. Participants completed the EPDS and MSPSS at the time of the group (T1) and at follow-up (T2). The groups and individual follow-ups were recorded and transcribed. Comparison of means and individual levels of change were used to analyse the quantitative data, alongside ‘process evaluation’ data (Moore et al., 2014). Thematic analysis was used to analyse the qualitative data. Results: Overall, a comparison of means found that the EPDS scores remained relatively stable from group (M= 6.83, SD= 3.35) to individual follow-up (M= 6.91, SD= 3.91). Similarly, scores on the MSPSS remained relatively stable from group (M= 6.18, SD= .63) to follow-up (M= 6.17, SD= .58). Individual levels of change were also explored. A ‘process evaluation’ was completed which included sample, reach, drop-out rates, and implementation/ fidelity of the intervention. Four higher-order themes and several sub-themes were identified in the qualitative analysis; 1) “This is about you, you are important” 2) “Leaving one kind of life and starting another one” 3) A search for connection, 4) Changes to interpersonal relationships. Discussion/ conclusion: This study is unable to conclude whether the brief “IPT-informed” intervention is accessible and acceptable to women in the perinatal period. Whilst mothers who took part reportedly benefitted from and enjoyed the intervention, the study identified several limitations and refinements that are required for future studies to address to adequately assess the accessibility and acceptability of the brief “IPT-informed” intervention for perinatal women. Generally, the intervention does not seem to have any adverse effects for expectant and new mothers. However, individual levels of change did show a slight deterioration for four mothers on their EPDS scores from T1 to T2. Due to the design of the study, it is difficult to deduce whether this was due to the intervention and whether the intervention prevented more significant deterioration amongst participants. Evidence from this study highlights that a further pilot/feasibility study is required addressing some of the refinements and limitations noted in the results and discussion, prior to a larger scale RCT examining efficacy of the intervention on the prevention on PND.

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