Parent experienced effects of a cross sectoral intervention for expecting and new parents in vulnerable positions: a realist evaluation

Theme: Equality in maternal, neonatal, and family health
Subtheme: Care for women and birthing families in challenging life situations
Authors: Louise Thomsen*1, Marianne Stistrup Frederiksen1, Charlotte Overgaard1
1Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, 9220 Aalborg Øst, Denmark
*Presenting author

Keywords: Challenging life situations, Continuity of care, Interventions, Mental health, Parenthood, Pregnancy, Public health, Qualitative
Title: Parent experienced effects of a cross sectoral intervention for expecting and new parents in vulnerable positions
Background: A child’s health and life chances are influenced by the mother’s mental health, socio-economic position, place of living and ethnicity already before birth. Evidence show that early interventions benefit the health and wellbeing of parents living with mental health- and social risks. The objective of this study is to contribute to the theory base of an early cross sectoral intervention for expecting and new parents in vulnerable positions, in the Northern Region of Denmark.
Methods and materials: The study is part of a realist evaluation of the cross sectoral intervention. 25 realist interviews were conducted with new parents who were offered the intervention.
Findings: Preliminary findings show that parents benefit from uncovering their vulnerabilities in a safe and compassionate space with their midwife. Early bridging by a known health professional to other services and continuity increases parents’ feeling of being in safe hands before and after birth. Uncovering vulnerability is experienced as a relief or leading to parents feeling judged depending on professionals’ approach and services offered. Parents with a history of mental illness or social disadvantage are well prepared or on their guards when entering the intervention. Greater emphasis on parenthood and a greater emphasis on fathers’ experience of birth and of becoming a father were suggested by parents. Parents benefit from group-based services by meeting likeminded parents in the context of known health and mental health professionals.
Conclusion: Continuity and compassionate health professionals prove central for parents to profit. The intervention varies across the region due to different implementation practices and service histories. However, most but not all parents felt that the intervention they were offered after the screening met their needs. The intervention can ideally be refined to meet greater diversity. Greater emphasis on parenthood and fatherhood were suggested.