Evaluation of an intervention aimed at supporting new parents: the Baby Newsletter project

Costantino Panza, Alessandro Volta, Serena Broccoli, Laura Bonvicini, Sally Kendall, Maddalena Marchesi, Paolo Giorgi Rossi, Costantino Panza, Alessandro Volta, Serena Broccoli, Laura Bonvicini, Sally Kendall, Maddalena Marchesi, Paolo Giorgi Rossi

Abstract

Background: Anticipatory guidance for parents is commonly used to improve parenting skills. The objective of this pre/post-intervention controlled study was to evaluate the effectiveness of a periodic newsletter with advice on childcare and development in improving parenting self-efficacy.

Methods: This was a non-randomized pre/post-intervention controlled study. All the parents of children born between September 2014 and December 2015 resident in the S. Ilario d'Enza municipality (Italy) received eight Baby Newsletters. Parents resident in other municipalities of the same Health District were the control. Parents with linguistic barriers or with preterm or hospitalized children were excluded. Improvement in parenting self-efficacy was measured through the TOPSE (Tool to Measure Parenting Self-Efficacy) questionnaire during the first week (t0) after delivery and at 5 (t1) and 12 months (t2) of life at two vaccination appointments. A score ranging from 0 to 60 was computed for each of the eight domains investigated by the TOPSE. Variations of each TOPSE score between delivery and 12 months in the two groups were compared, adjusting for parity, education, age of parents, and child's sex, and stratifying by parity and education.

Results /findings: One hundred thirty-six families accepted to participate in the study. Scores at 12 months were higher than 1 week after delivery in both groups for all TOPSE domains. The improvement was slightly stronger in the Newsletter group for almost all the skills except learning and knowledge [difference in the mean of variation: -0.48 (95% CI: - 3.17; 2.21)]; the difference was significant only for play and enjoyment [2.18 (95% CI: 0.12; 4.25)]. The increase in scores in almost all domains was more pronounced for parents with high education level at first child.

Conclusions: The intervention was effective in improving parents' ability to play. However, it risks worsening existing differences between parents with high and with low education levels.

Trial registration: Clinical trial registration: NCT03268408 .

Keywords: Anticipatory guidance; Infant; Parent-child relationship; Parenting; Primary care; Self-efficacy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Reggio Emilia province. The intervention and the study area are highlighted
Fig. 2
Fig. 2
Flowchart of the study and timeframe for questionnaires and Baby Newsletter
Fig. 3
Fig. 3
Distribution of differences between baseline (t0) and t2 values for parenting skills available in baseline questionnaires in the Baby Newsletter and in the control group. Scores are based on a six-item scale, each item has 0–10 values, and the total score ranges from 0 to 60. We also report mean value of the difference in within-groups and difference-in-differences with 95% confidence intervals. * Linear regression of delta score on group adjusted for child’s sex, parents’ age, parity, and education level. (R2: emotion = 0.0880, play = 0.0537, empathy = 0.0357, pressure coping = 0.0326, self-acceptance = 0.0379, learning = 0.0266)
Fig. 4
Fig. 4
Mean score of TOPSE scale for treatment and time. Scores are based on a six-item scale, each item has 0–10 values, and the total score ranges from 0 to 60

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