New technology for new parents: Using technology to help parents bond with and care for their new baby

INTERVENTION: A hospital‐based clinical psychologist or social worker with additional training will deliver three individualised 1 hour virtual home visits (via telehealth) to women and their partners (if applicable). During the first virtual home visit (when mothers are approximately 26 weeks pregnant) parents will complete ‘Baby CHAT’, a manualised psychoeducational intervention designed to improve parental mentalization and emotional attachment during pregnancy (Cox et al 2021). The parent's will receive the Baby CHAT booklet prior to the virtual‐home‐visit and during the visit be guided through fetal development and postnatal social development of the baby. Parents will be guided to develop reflective functioning and bond with the baby. The booklet may be utilised throughout the pregnancy and provides parents with an overview of baby’s development from conception onwards and what they might say if they could talk in the first few weeks and months after birth. The booklet provides workspaces to enable parents’ to document aspects of mentalization, attachment and bonding. The booklet also provides resources for singing, playing music and talking/reading/telling stories to the unborn baby. Importantly, mindfulness techniques for the parent are also discussed as well as how to incorporate ‘Baby CHAT’ into everyday life. Time commitment to Baby Chat documentation will vary according to parental engagement with the Baby Chat intervention. Women and their partners (if applicable) will also attend two 30‐minute 4‐D ultrasound sessions at the Women's and Children's Hospital (at 28 and 34 weeks gestation) where a sonographer will conduct the ultrasound while a psychologist or social worker will work with parents‐to‐be to get to know their unborn baby via mentalization app CONDITION: Mental Health ‐ Depression Mental Health ‐ Other mental health disorders Pregnancy;Postpartum problems;Depression;Child bonding and attachment;Parenting Problems;Infant Development; ; Pregnancy ; Postpartum problems ; Depression ; Child bonding and attachment ; Parenting Problems ; Infant Development Public Health ‐ Health service research Reproductive Health and Childbirth ‐ Childbirth and postnatal care SECONDARY OUTCOME: Impact evaluation of the views of the health professionals delivering the intervention, reported experience and satisfaction with delivering the intervention in terms of time taken and the response of parents using a free‐response questionnaire developed for this purpose.[At completion of study.] Primary outcome 4: Postnatal reflective functioning measured by the Parental Reflective Functioning Questionnaire (PRFQ). ; ; The online outcomes questionnaire described above will be sent to all randomised women approximately 2 months postnatal, with the exception of women with severe adverse outcomes (e.g. fetal or neonatal death).[2 and 6 months postnatal ; ; ] Primary outcome 5: Infant crying questionnaire assessing knowledge of infant crying and assessing number of times of frustration with infant crying (Period of Purple Cry). ; ; The online outcomes questionnaire described above will be sent to all randomised women approximately 2 months postnatal, with the exception of women with severe adverse outcomes (e.g. fetal or neonatal death).[2 and 6 months postnatal] Secondary outcome 1: Antenatal health behaviours measured by the prenatal health behaviours scale (PHBS). ; ; ; [36‐38 weeks gestation] Secondary outcome 2: Maternal depressive symptoms measured using scores on the Edinburgh Postnatal Depression Scale (EPDS). ; ; ; [2 and 6 months postnatal ; INCLUSION CRITERIA: < 24 weeks pregnant Singleton pregnancy Identified at the antenatal booking appointment as being at moderate psychosocial risk. PRIMARY OUTCOME: Antenatal attachment measured by the maternal antenatal attachment scale (MAAS).; ; The online outcomes questionnaire described above will be sent to all randomised women approximately 36‐38 weeks gestation, with the exception of women with severe adverse outcomes (e.g. fetal death).; [36‐38 weeks gestation] Antenatal reflective functioning measured by the prenatal parenting reflective functioning questionnaire (P‐PRFQ).; ; The online outcomes questionnaire described above will be sent to all randomised women approximately 36‐38 weeks gestation, with the exception of women with severe adverse outcomes (e.g. fetal death)..[36‐38 weeks gestation; ; ] Parenting competence and attachment measured by parenting stress index (PSI‐IV) parent domain subscales.; ; The online outcomes questionnaire described above will be sent to all randomised women approximately 2 months postnatal, with the exception of women with severe adverse outcomes (e.g. fetal or neonatal death).[2 and 6 months postnatal] ; The online outcomes questionnaire described above will be sent to all randomised women approximately 36‐38 weeks gestation, with the exception of women with severe adverse outcomes (e.g. fetal death).. ; The online outcomes questionnaire described above will be sent to all randomised women approximately 2 months postnatal, with the exception of women with severe adverse outcomes (e.g. fetal or neonatal death). ; ] Secondary outcome 3: Eligibility rates of the number participants deemed eligible against inclusion/exclusion criteria by 25 weeks pregnant within the pre‐screened population. Obtained from audit of online pre‐screening and consent to contact records.[End of the recruitment period.] Secondary outcome 4: Consent rates, assessing the number consenting to participate by 25 weeks pregnant within the eligible population. Obtained from audit of online pre‐screening records and online consent to participate records.[End of the recruitment period.] Secondary outcome 5: Randomisation rates, assessing the number randomised from the number consenting to participate by 25 weeks pregnant. Obtained from audit of online pre‐screening records and online consent to participate records.[End of the recruitment period.] Secondary outcome 6: Questionnaire return rates. Obtained from audit of response rates to online questionnaires.[Trial entry; 36‐38 weeks gestation; 2 months postnatal; 6 months postnatal.] Secondary outcome 7: Attendance at the intervention and reasons for non‐attendance. The outcome will be obtained by audit of attendance and follow‐up of non‐attendance reasons via phone call to participants for virtual home visits and 4‐D ultrasounds.[26, 28 and 34 weeks gestation 2 weeks postnatal; 6 weeks postnatal.] Secondary outcome 8 Intervention quality will be assessed using 9 item questionnaire (antenatal) and 8 item questionnaire (postnatal) which we have developed for this purpose. Items ask about the length/timing of the interventions, what was enjoyed, what could be improved and what was most useful about the interventions. [36‐38 weeks gestation; 2 months postnatal; and 6 months postnatal.]