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An integrated parenting intervention for maternal depression and child development in a low‐resource setting: Cluster randomized controlled trial
Author(s) -
Husain Nusrat,
Kiran Tayyeba,
Fatima Batool,
Chaudhry Imran B.,
Husain Mina,
Shah Sadia,
Bassett Paul,
Cohen Nancy,
Jafri Farhat,
Naeem Shehla,
Zadeh Zainab,
Roberts Chris,
Rahman Atif,
Naeem Farooq,
Husain Muhammad Ishrat,
Chaudhry Nasim
Publication year - 2021
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.23169
Subject(s) - randomized controlled trial , edinburgh postnatal depression scale , psychological intervention , medicine , anxiety , depression (economics) , cluster randomised controlled trial , pediatrics , child development , psychology , clinical psychology , psychiatry , depressive symptoms , economics , macroeconomics
Background Rates of depression among Pakistani mothers are high, leading to poor developmental outcomes in their children. This study tested the effectiveness of a manualized integrated parenting program; Learning through Play Plus (LTP+) for maternal depression in Karachi, Pakistan. Methods A cluster randomized control trial conducted from January 2014 to December 2015 across 120 villages in Karachi. A total of 774 depressed mothers aged 18–44 years with children aged 0–30 months old, were included. Villages were randomized to receive LTP+ added to treatment as usual (TAU) or TAU alone. Primary outcomes were severity of maternal depression at 3 and 6 months measured by the Edinburgh Postnatal Depression Scale and child socio‐emotional development at 6 months measured by the Ages and Stages Questionnaire (ASQ). Secondary outcomes included maternal anxiety, quality of life, social support, parenting competence, and knowledge about child development. Results Mothers in the LTP+ group reported significantly lower depression scores compared to those in the TAU group (6.6 vs. 13.8, effect size [ES]: −7.2; 95% confidence interval [CI]: −8.2, −6.1) at 3 and 6 months (7.2 vs. 12.00; ES: −4.6; 95% CI: −5.9, −3.4). Child socio‐emotional development at 6 months was significantly better in the LTP+ group on all domains of the ASQ. There were also statistically significant improvements on all secondary outcomes at 3‐ and 6‐month follow‐up. Conclusion In low‐resource settings like Pakistan, low‐cost integrated parenting interventions delivered by lay health workers can provide effective treatment for depressed mothers, leading to improvements in child development.