A feasibility study of Online Mellow Bumps: A Turkish pilot study of an online group-based antenatal parenting intervention.

BACKGROUND: As a result of the COVID-19 pandemic, Mellow Parenting proposed online strategies for some of their interventions. One such intervention was Mellow Bumps - becoming Online Mellow Bumps. The objective of this study was to evaluate the implementation of antenatal parenting intervention Mellow Bumps in an online format and determine if this can be done safely and without detriment to pregnant women in Turkey. METHOD: The study used an exploratory study design to investigate routine evaluation data collected pre- and post-intervention. Outcomes were online feasibility, mental health symptoms (depression, anxiety and stress), maternal subjective well-being, perceived quality of relationship with baby, maternal confidence and maternal social connectivity. 128 mums-to-be took part in the intervention between January 2021 and May 2021 from a total of 21 different provinces in Turkey. RESULTS: 57 pre- and post-intervention responses were eligible for analysis. This gives a response rate of 44.5% for evaluation, though the intervention completion rate was high at 89.5%, suggesting the intervention is engaging and accessible. Improvements were found for maternal stress levels, maternal subjective well-being and perceived relationship with baby. Improvements were also found for maternal confidence and maternal social connectivity. CONCLUSIONS: This is the first study to evaluate the antenatal parenting intervention Mellow Bumps in an online format, namely Online Mellow Bumps. The online format makes the programme accessible for at-risk mothers and families, with the potential to continue reaching wider audiences beyond the pandemic who otherwise might struggle to access support. The findings show that the online group can be effective in improving mental health symptoms and mental well-being, supporting expectant mothers before the baby is born. Future research using a control group, a larger and more inclusive sample, and assessing the longer-term effects on parent and child would be beneficial.

"There's more love between us": The parental experience of attending Mellow Babies, a targeted, early intervention program for parents and their babies.

It is recognized that parenthood in the context of psychosocial adversity can have negative implications for infant development. Parenting programs are the first line of intervention to improve outcomes for families; however, evidence for the effectiveness of group-based, targeted early interventions is still scarce. Preliminary findings indicate Mellow Babies (MB) as a promising group-based parenting program for families at risk for parenting difficulties. Using thematic analysis, we aimed to understand: (i) the aspects of the intervention that enabled parents to complete the program and (ii) the relational and behavioral changes perceived as valuable for parents and their babies post-intervention. In total, 68 parents residing in the United Kingdom were interviewed after completing MB (49 mothers and 19 fathers; 88% self-identified as British). Three themes and six subthemes were generated from the data. Parents identified several intervention components as beneficial, including the facilitators' interpersonal skills and multi-dimensional, group-based approach. Participant reflections highlighted three underlying mechanisms that enabled positive change: (i) the sense of community cultivated within the group, (ii) the process of formulating and re-conceptualizing one's difficulties, and (iii) the opportunity to reshape interpersonal interactions. Findings are discussed within the context of perinatal and infant mental health.

Se reconoce que la paternidad/maternidad dentro del contexto de la adversidad sicosocial puede tener implicaciones negativas para el desarrollo del infante. Los programas sobre la crianza son la línea frontal de intervención para mejorar los resultados para las familias, sin embargo, la evidencia para la eficacia de las intervenciones tempranamente identificadas, con base en el grupo, es escasa. Los resultados preliminares indican que Bebés Apacibles (Mellow Babies / MB) es un prometedor programa de crianza con base en el grupo para familias bajo riesgo de dificultades en la crianza. Haciendo uso de análisis temáticos, nos propusimos comprender: i) los aspectos de la intervención que les permite a los progenitores completar el programa y ii) los cambios relacionales y de comportamiento que se percibieron como valiosos para los progenitores y sus bebés con posterioridad a la intervención. En total, se entrevistaron 68 progenitores residentes del Reino Unido después de completar MB (49 mamás y 19 papás; 88% autoidentificados como británicos). De la información surgieron tres temas y seis subtemas. Los progenitores identificaron como beneficiosos varios componentes de la intervención, incluyendo las habilidades interpersonales de quienes facilitaban la participación y el acercamiento multidimensional con base en el grupo. Las reflexiones de los participantes subrayaron tres mecanismos subyacentes que permitieron el cambio positivo: i) el sentido de comunidad cultivado dentro del grupo; ii) el proceso de formular y reconceptualizar las propias dificultades; y iii) la oportunidad de volver a darle forma a las interacciones interpersonales. Los resultados se discuten dentro del contexto de la salud mental perinatal y del infante.

On reconnaît généralement que la parentalité dans le contexte d'adversité psychosociale peut avoir des implications négatives pour le développement du bébé. Les programmes de parentage sont la première ligne d'intervention afin d'améliorer les résultats pour les familles. Cependant les preuves de l'efficacité d'interventions précoces ciblées et basées sur un groupe sont encore rares. Des résultats préliminaires indiquent que Bébés d'humeur joyeuse, Mellow Babies (MB) est un programme de parentage basé sur un groupe prometteur pour les familles à risque de difficultés de parentage. En utilisant une analyse thématique nous nous sommes donné pour but de comprendre: i) les aspects de l'intervention qui permettent aux parents de finir le programme et ii) les changements relationnels et comportementaux qui sont perçus comme étant précieux pour les parents et leurs bébé après l'intervention. Au total 68 parents résidant au Royaume Uni ont été interviewés après avoir terminé le programme MB (49 mères et 19 pères; 88% s'étant auto-identifiés comme britanniques). Trois thèmes et six sous-thèmes ont émergé des données. Les parents ont identifié plusieurs composantes de l'intervention comme étant bénéfiques, y compris les compétences interpersonnelles du facilitateur ou de la facilitatrice et son approche multi-dimensionnelle, basée sur un groupe. Les réflexions des participants ont mis en lumière trois mécanismes sous-jacents qui permettait un changement positif: i) le sens de communauté cultivé au sein du groupe; ii) les processus de formulation et de ré-conceptualisation de ses propres difficultés; et iii) l'opportunité de refaçonner les interactions interpersonnelles. Les résultats sont discutés dans le contexte de la santé mentale du nourrisson et périnatale.

Promoting sensitive parenting in 'at-risk' mothers and fathers: A UK outcome study of Mellow Babies, a group-based early intervention program for parents and their babies.

BACKGROUND: The objective of this study was to evaluate the effectiveness of Mellow Babies (MB) in the UK. MB is a 14-week early parenting intervention program that is delivered in groups and is targeted at 'at-risk' parents (both mothers and fathers) and their babies up to 18 months old. METHOD: The study used a pragmatic pre-post intervention design. Outcomes were parental mental health, parenting confidence, quality of life, socio-emotional development of children, and perceived parent-child relationship. Fifteen groups representing n = 91 parent-baby dyads were recruited across the UK between 2017-2018. The sample consisted of 10 Mellow Mums groups (70 mother-baby dyads) and 5 Mellow Dads groups (21 father-baby dyads). Intention-to-treat and 'completer' analyses were performed. RESULTS: Findings suggest short-term positive outcomes for parents attending MB. Completion of the program was associated with significant improvements in anxiety and overall wellbeing, parenting confidence, and perceived closeness of the parent-child relationship. The significance of these improvements, except for parenting confidence, was maintained in the intention-to-treat analysis. MB engaged and retained a high proportion of parents who could be considered 'at-risk' and benefitted fathers and mothers attending the intervention equally. CONCLUSIONS: This is the first prospective study to explore MB participation for both mothers and fathers and to indicate engagement and potential benefits specifically for 'at-risk' parents. Findings further demonstrate the effectiveness of MB as an early intervention program for parents experiencing psychosocial difficulties. Replication by studies using a contrast or control group also incorporating follow-up data would further improve the evidence base for MB.

Mellow Babies and Mellow Toddlers: Effects on maternal mental health of a group-based parenting intervention for at-risk families with young children.

BACKGROUND: Parental risk factors can have a significant detrimental impact on child development, yet most parenting interventions do not address parental mental health. There is also a dearth of evidence regarding parenting interventions for families with children under two years old. Mellow Parenting (MP) is a suite of parenting interventions targeting at-risk families with complex needs, including those with very young children. Preliminary studies suggest that MP can improve both parent and child outcomes, but no evaluation has been conducted in routine practice. METHODS: Using a real-world design we analysed routine data from a UK cohort of n = 183 mother-child dyads, collected over a 21-month period. Data were gathered immediately pre- and post-intervention. Outcomes included maternal mental health, parenting confidence, daily parenting stress, and child behaviour. Intention-to-treat and 'completer' analyses were performed. Associations between attendance, participant demographics, and pre-post change in outcomes were modelled. RESULTS: MP participation was associated with improvements in maternal mental health (d = 0.36), parenting confidence (d = 0.42), and a component of child psychosocial behaviour (conduct problems; d = 0.36), but not overall child difficulties, or daily parenting stress. Mothers with a partner experienced larger benefits in mental health and parenting confidence compared to single mothers. Younger mothers, and those with a history of mental health problems, attended more intervention sessions. LIMITATIONS: The study used real-world data and was thus uncontrolled, limiting causal interpretations. CONCLUSIONS: This is the first study to explore MP participation on a multi-site national level and suggests that group-based parenting interventions may be effective for at-risk families. These results should be expanded upon via controlled studies that incorporate follow-up data.