How acceptable is a group Psychosocial intervention for postnatal depression in British South Asian women (ROSHNI-2)?

Conference:

SAPC ASM 2020 - cancelled due to pandemic

Talk Code:

P.4

Presenter:

Carolyn Chew-Graham

Twitter:

@CizCG

Co-authors:

Saadia Aseem, Rebecca McPhillips, Jasmin Begum, Anna Taylor, Nusrat Husain, Penny Bee.

Author institutions:

Keele University, Lancashire and South Cumbria NHS foundation Trust, University of Manchester, East Lancashire Hospitals NHS Trust.

Problem

Postnatal depression (PND) is a common disorder with negative impact on mothers, infants and families. The World Health Organization states that globally 13% of women experience a mental disorder, primarily depression, following childbirth, increasing to 19.8% in low and middle income countries. In the UK, studies suggest that PND is more common in British South Asian (BSA) women than in Caucasian women, which suggests that ethnic and cultural differences are significant risk factors for developing PND. The Positive Health Programme (PHP), is a culturally-adapted group CBT intervention for PND, and is being tested in a multi-centred Randomised Trial.

Approach

A nested process evaluation is being conducted, with semi-structured interviews with women who have completed PHP, women who ‘dropped out’, and trial therapists, to explore acceptability of the intervention from the perspectives of women and therapists; acceptability of the training and challenges to delivery of the intervention from the perspectives of the therapists. Interviews were digitally recorded with consent. Interviews were transcribed verbatim, the transcripts forming the data for analysis. An initial thematic analysis was conducted within each data-set, followed by a framework analysis, using the Theoretical Framework of Acceptability (TFA) (Sekhon et al, 2017)

Findings

Nineteen women who have completed PHP were interviewed, along with 3 ‘drop-outs’, and 11 therapists. Analysis will be presented from five of the constructs of the TFA: Affective attitudesWomen who had completed the group programme were positive about the support given in order to attend the group, the value of making friends with other group members and sense of achievement following completion of the course.Intervention coherenceWomen reported that leaving the house to attend the group was a positive step. Strategies learned in the group seemed to make sense to participants. Therapists felt the group programme made sense to them, and to their Community.Perceived effectivenessWomen felt the sessions in the group programme provided useful information, helping them to gain confidence, develop ways of managing every-day problems, and improve their mood. Therapists reflected on the key features of the programme which were helpful to women.BurdenEven though transport and creche facilities were provided, the effort of leaving the house and impact on family were too much for some women to manage. Self-efficacyFollowing the training, the therapists had confidence that that they could deliver the programme. Women reported that learning to prioritise their own needs as a key result of participation in ROSHNI.

Consequences

Using the TFA to explore acceptability of the ROSHNI group intervention for women with PND, from the perspectives of women and therapists, we have established that the programme is acceptable and valued, and has the potential to support British South Asian women with post-natal depression.

Submitted by:

Carolyn A. Chew-Graham

Funding acknowledgement:

This work presents independent research funded by the National Institute for Health Research (NIHR) HTA Project: 14/68/08 - Multi Centre RCT of a group psychOlogical intervention for poStnatal depression in britisH mothers of south asiaN origIn - ROSHNI-2 (The word Roshni means ‘light’ in Urdu/Hindi)