A qualitative exploration of active ingredients and mechanisms of action of an online singing programme with mothers experiencing postnatal depression during the COVID-19 pandemic: SHAPER-PNDO study. (preprint)

Background Social distancing restrictions and the suspension of in-person treatment and support contributed to an increase in postnatal depression during the coronavirus disease 2019 (COVID-19) pandemic. Creative health interventions can help to alleviate anxiety and depression, with studies showing that singing is particularly effective for supporting the mental health of new mothers. We adapted an in-person group singing programme (Breathe Melodies for Mums (M4M)) to online delivery during the COVID-19 pandemic to support the mental health of new mothers, and, in a feasibility study, found improvements in postnatal depression (PND) symptoms at 6-month follow up. The current qualitative study aimed to explore how and why M4M-online impacted the mental health of those taking part.Methods We took a theory-based approach using the Ingredients in Arts in Health (INNATE) Framework of ‘active ingredients’ and the Multi-level Leisure Mechanisms Framework of ‘mechanisms of action’ to identify and categorise intervention components and change mechanisms. Iterative consensus building between three researchers were complemented by qualitative semi-structured online interviews with 24 women experiencing PND symptoms who took part in M4M-online. Data were analysed inductively using reflexive thematic analysis.Results Consistency was found between the online and in-person interventions in active ingredients relating to project design, content, programme management and the composition of the group. Key differences were in the social and contextual ingredients. Psychological, social and behavioural mechanisms for improved mental health and wellbeing included: 1) Increased self-confidence as a mother, 2) Increased positive emotional responses, 3) A supported change in identity, 4) Reduced loneliness and isolation, 5) Increased social bonding and connections with family and 6) Enhanced sense of time through new routines.Conclusions Participating in online group singing can support new mothers experiencing PND by triggering psychological, social and behavioural responses that lead to improved mental health. Key programme features are identified which can be used to design future online creative health interventions or tailor in-person activities for remote delivery to support populations who may face practical and social barriers to attending in-person.

The Social and Political Impact of the COVID-19 Pandemic: An Introduction

The COVID-19 pandemic highlights the importance of responsive institutions: governments and communities coordinating policy changes;media, social networks, and officials swiftly and accurately conveying information;and an engaged public. This special issue explores social and political factors that both shaped initial response to the pandemic, and were altered by it. Institutional inequalities and variations in government response created significant differences in health outcomes even as the contagious nature of the pandemic linked spaces and people. Thus COVID-19 created new crises, exacerbated inequalities, and led to broad social changes. Social scientists will spend decades unraveling the consequences of COVID-19. This issue challenges scholars to apply existing theories and frameworks, but also to see the pandemic as an event that stimulates us to reevaluate settled paradigms.