Effectiveness and cost-effectiveness of an electronic mindfulness-based intervention to improve maternal mental health in the peripartum: study protocol for a randomised controlled trial.

BACKGROUND: Perinatal women are highly vulnerable to developing mental health issues and particularly susceptible to a recurrence of psychiatric illness. Poor mental health during the perinatal period can have long-term impacts on the physical and psychiatric health of both mother and child. A potentially useful strategy to improve women's mental health is through a mobile application teaching mindfulness, an evidence-based technique helping individuals focus on the present moment. METHODS: A mixed method, prospective randomised controlled trial. The study group comprise women aged 18 years and over, who are attending the public and private maternity clinics at Mater Mothers' Hospital. A sample of 360 prenatal women will be randomised into the intervention group (with the use of the mindfulness app) or usual care. Participants will remain in the study for 11 months and will be assessed at four timepoints for changes in postnatal depression, mother-infant bonding, and quality of life. A cost-effectiveness evaluation will also be conducted using quality-adjusted life year (QALY) calculations. A random selection of intervention participants will be invited to attend focus groups to give feedback on the mindfulness app. DISCUSSION: Previous studies have found mindfulness interventions can reduce stress, anxiety, depression, and sleep disturbances in a prenatal population. The risks of the intervention are low, but could be of significant benefit for women who are unable to attend face-to-face appointments due to geographical, financial, or time barriers; during endemic or pandemic scenarios; or due to health or mobility issues. TRIAL REGISTRATION: This study was approved by the Mater Misericordiae Human Research Ethics Committee (83,589). Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622001581752 ( https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385107&isReview=true ). Registered on 22 Dec. 2022.

Mental health symptoms in children and adolescents during COVID-19 in Australia.

OBJECTIVE: COVID-19 has led to disruptions to the lives of Australian families through social distancing, school closures, a temporary move to home-based online learning, and effective lockdown. Understanding the effects on child and adolescent mental health is important to inform policies to support communities as they continue to face the pandemic and future crises. This paper sought to report on mental health symptoms in Australian children and adolescents during the initial stages of the pandemic (May to November 2020) and to examine their association with child/family characteristics and exposure to the broad COVID-19 environment. METHODS: An online baseline survey was completed by 1327 parents and carers of Australian children aged 4 to 17 years. Parents/carers reported on their child's mental health using five measures, including emotional symptoms, conduct problems, hyperactivity/inattention, anxiety symptoms and depressive symptoms. Child/family characteristics and COVID-related variables were measured. RESULTS: Overall, 30.5%, 26.3% and 9.5% of our sample scored in the high to very high range for emotional symptoms, conduct problems and hyperactivity/inattention, respectively. Similarly, 20.2% and 20.4% of our sample scored in the clinical range for anxiety symptoms and depressive symptoms, respectively. A child's pre-existing mental health diagnosis, neurodevelopmental condition and chronic illness significantly predicted parent-reported child and adolescent mental health symptoms. Parental mental health symptoms, having a close contact with COVID-19 and applying for government financial assistance during COVID-19, were significantly associated with child and adolescent mental health symptoms. CONCLUSION: Our findings show that Australian children and adolescents experienced considerable levels of mental health symptoms during the initial phase of COVID-19. This highlights the need for targeted and effective support for affected youth, particularly for those with pre-existing vulnerabilities.

Primary mental health prevention in partners of mothers with a major mental illness: SMS4Dads.

BACKGROUND: Mental health promotion and prevention with expecting and new fathers has historically been challenging. Approximately 10% of this population report experiencing depression in the post-partum period and 18% report experiencing anxiety. This population may be further at risk if their partner has a mental illness. OBJECTIVE: To assess if information provided by SMS may be a way to reach a vulnerable population of new fathers with partners who have a mental illness. METHOD: Twenty-three new and expecting fathers who have partners with a mental illness were engaged in a qualitative assessment of their experience with the SMS4Dads programme. RESULTS: This analysis showed that at risk new fathers appreciated the information received during the programme and reported acting on this, making changes in the way they interact with their children. CONCLUSION: The combination of timely, accurate and practical information delivered in a novel way, likely contributed to the reports of improved interactions within the family unit.

COVID-19 unmasked: preschool children's negative thoughts and worries during the COVID-19 pandemic in Australia.

Background: The COVID-19 pandemic and its consequences are stressful for many children and their families. Previous research with school-aged children has shown that negative thoughts and worries can predict mental health symptoms following stressful events. So far preschool children have been neglected in these investigations. Objective: The aim of this study was to explore negative thoughts and worries that preschool aged children are having during the COVID-19 pandemic. Method: As part of a larger mixed-method study, caregivers of N = 399 preschoolers aged between 3 and 5 years (M = 4.41) answered open-ended questions about their COVID-19 related thoughts and worries. Reflexive thematic analysis was used to identify relevant themes from the qualitative data. A theoretical model of child thoughts and worries was developed based on these qualitative findings and the existing empirical and theoretical literature. Results: Caregivers gave examples that indicated that preschoolers had difficulties understanding causality and overestimated the risk of COVID-19 infection. Caregivers reported that their children expressed worries about getting sick and infecting others as well as about changes in daily life becoming permanent. Caregivers observed their children's preoccupation with COVID-19 and worries in conversations, play and drawings as well as in behavioural changes - increased arousal, cautiousness, avoidance and attachment-seeking behaviour. Conclusion: Preschool children can and do express negative thoughts and worries and have also experienced threat and increased vulnerability during the COVID-19 pandemic. A theoretical model is proposed that could inform assessments, interventions and future research in the field.

Antecedentes: la pandemia de COVID-19 y sus consecuencias son estresantes para muchos niños y sus familias. Investigaciones previas con niños en edad escolar han demostrado que los pensamientos negativos y las preocupaciones pueden predecir síntomas de salud mental luego de eventos estresantes. Hasta ahora, los niños en edad preescolar han sido desatendidos en estas investigaciones.Objetivo: El objetivo de este estudio fue explorar los pensamientos negativos y las preocupaciones que los niños en edad preescolar están teniendo durante la pandemia de COVID-19.Método: Como parte de un estudio más amplio de métodos mixtos, los cuidadores de N = 399 niños en edad preescolar de entre 3 y 5 años (M = 4,41) respondieron preguntas abiertas sobre sus pensamientos y preocupaciones relacionados con COVID-19. Se utilizó un análisis temático reflexivo para identificar temas relevantes a partir de los datos cualitativos. Se desarrolló un modelo teórico de los pensamientos y preocupaciones de los niños, basado en estos hallazgos cualitativos como también la literatura empírica y teórica existente.Resultados: Los cuidadores dieron ejemplos que indicaban que los niños en edad preescolar tenían dificultades para comprender causalidad, y sobrestimaban el riesgo de infección por COVID-19. Los cuidadores informaron que sus hijos expresaron preocupación por enfermarse e infectar a otros, así como también que los cambios en la vida diaria se vuelvan permanentes. Los cuidadores observaron la preocupación de sus hijos por el COVID-19 en conversaciones, juegos y dibujos, así como también en cambios de conducta: aumento de la alerta, cautela, evitación y comportamientos de búsqueda de apego.Conclusión: Los niños en edad preescolar pueden y logran expresar pensamientos y preocupaciones negativos, y también han experimentado amenaza y una mayor vulnerabilidad durante la pandemia de COVID-19. Se propone un modelo teórico que podría sustentar evaluaciones, intervenciones e investigaciones futuras en esta área.