A RCT of peer-mentoring for first-time mothers in socially disadvantaged areas (The MOMENTS Study)

Cupples, M. E.; Stewart, M. C.; Percy, A.; Hepper, P.; Murphy, C.; Halliday, H. L.
March 2011
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Mar2011, Vol. 96 Issue 3, p252
Academic Journal
Objective Interventions to reduce health inequalities for young children and their mothers are important: involving peers is recommended, but evidence of value for this approach is limited. The authors aimed to examine the effect of an innovative tailored peer-mentoring programme, based on perceived needs, for first-time mothers in socio-economically deprived communities. Design Randomised controlled trial; parallel qualitative study with purposive samples using semistructured interviews. Setting Socio-economically disadvantaged areas, Belfast. Participants Primigravidae, aged 16-30 years, without significant co-morbidity. Intervention Peer-mentoring by a lay-worker fortnightly during pregnancy and monthly for the following year, tailored to participants' wishes (home visits/telephone contacts), additional to usual care. Main outcome measures Infant psychomotor and mental development (Bayley Scales of Infant Development (BSID-II)) at 1 year, assessed by an observer blinded to group allocation. Mothers' health at 1 year postnatal (SF-36). Results Of 534 women invited, 343(64%) participated; 85%, with their children, completed outcome assessments (140 of 172 intervention; 152 of 171 controls). Intervention and control groups did not differ in BSID-II psychomotor (mean difference 1.64, 95% CI ⇔'0.94 to 4.21) or mental (⇔'0.81, ⇔'2.78 to 1.16) scores, nor SF-36 physical functioning (⇔'5.4, ⇔'11.6 to 0.7) or mental health (⇔'1.8, ⇔'6.1 to 2.6). Women valued advice given in context of personal experience of child-rearing. Mentors gained health-related knowledge, personal skills and new employment opportunities. Conclusions Despite possible longer-term social advantage, this peer-mentoring programme showed no benefit for infant development or maternal health at 1 year. Further rigorous evaluation of important outcomes of complex interventions promoting health for children in socially disadvantaged communities is warranted.


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