The Baby Triple P Online positive parenting programme for mothers accessing community perinatal mental health care (the OPAL study): A feasibility study protocol

Anja Wittkowski^1,2,3*Henna Lemetyinen^1,2,3Holly E Reid^1,2,3Trinity Perruzza-Powell^2,3Lynsey Gregg^1,2,3

• ¹The University of Manchester, School of Health Sciences, Division of Psychology and Mental Health, Manchester, England, United Kingdom, Manchester, United Kingdom
• ²Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
• ³Perinatal Mental Health and Parenting (PRIME) Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom

Background: Perinatal mental health difficulties can negatively impact maternal wellbeing, which in turn can impact the mother-infant bond. Although parenting interventions have been found to be effective, they are often not routinely offered in mental health services as additional psychosocial support. Thus, the aims of this study are a) to examine the feasibility of recruiting mothers, engaging them in an online parenting intervention and retaining them in the study and b) to explore the acceptability of this type of intervention in mothers and specialist perinatal mental health staff. We will also explore any changes in relevant outcomes for mothers. Methods: In this uncontrolled feasibility study, women experiencing moderate to severe mental health problems, who are in the later of stage of their pregnancy or mother to a baby up to 12 months old, will be recruited from a perinatal community mental health service in the Northwest of England, UK. Consented participants will be offered the self-paced Triple P for Baby Online parenting intervention alongside any service support. To support engagement, the research team will offer four check-in phone calls and text messages to support participants. Outcomes measures, completed online at baseline and again at post-intervention ten weeks after study enrolment, will examine changes in maternal mental health (depression, anxiety, stress), wellbeing, maternal self-efficacy and the perceived mother-infant bond. Results: Descriptive summaries will be produced for feasibility outcomes, including recruitment and retention rates and number of sessions completed. We will use paired t-test or Wilcoxon signed rank test for pre-and post-intervention questionnaire data and the reliable change index to explore any changes in outcomes. Mothers (n=10-20) and staff (n=5-10) will be interviewed to explore acceptability, engagement and implementation factors. Interview data will be analysed using framework analysis. Discussion: This is the first study to examine the feasibility of engaging women in a self-paced, online parenting intervention and its acceptability within a NHS perinatal community mental health service. We will also explore its potential benefits in terms of outcomes. If progression to a full trial is indicated, this study will inform future study design, recruitment methods, eligibility criteria and outcome measures.