A proactive child protection programme for mothers with psychological distress: an extended project
| ISRCTN | ISRCTN13566256 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN13566256 |
- Submission date
- 16/06/2025
- Registration date
- 17/06/2025
- Last edited
- 17/06/2025
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
The postpartum period is a critical time for women as they may experience the onset or relapse of psychological distress in response to new challenges, and physiological and psychological changes. Mothers with psychological distress or emotional problems tend to exhibit behaviours that negatively affect their family relationships and their children’s development. While the needs of this vulnerable group are increasingly being recognised in Hong Kong, there is currently a shortage of supportive services to address the needs of these women and promote the health and development of their babies. In a prior pilot project, we developed an advanced training course for certified Pui Yuet to equip them with the knowledge and skills of managing mothers with emotional problems/psychological distress. They were recruited as neighbourhood buddies in a proactive child protection programme to care for mothers and 0-24-month babies during home visits. The findings of the pilot project demonstrated improvements in parenting competency, parental stress, anxiety and depression with small (0.25) to moderate (0.52) effect sizes among the participating mothers after programme completion. However, the small sample sizes limited the power of the study. A larger sample size is needed to confirm the effects of this child protection programme.
The objectives of the project are to:
1. Provide an advanced training course for recruited Pui Yuet to act as childcare providers
2. Provide perinatal and childcare support services, by trained Pui Yuet, for poverty families with 0–24-month babies for 3-6 months
3. Provide parenting coaching for mothers in need
4. Provide counselling services for mothers in need
5. Establish a supportive network for mothers living in the district of the New Territories East Cluster (NTEC)
6. Evaluate the effects of the proactive child protection programme in terms of maternal, children and Pui Yuet outcomes
Who can participate?
Women with emotional problems/psychological distress who have 0-24-month-old babies
What does the study involve?
In our pilot study, an advanced online training course was developed and 45 certified Pui Yuet completed the training. In phase one, we will recruit more Pui Yuet to attend this training if needed. In phase two, 60 mothers with emotional problems/psychological distress will be recruited to attend a 12-week neighbourhood buddies programme. During the programme, each mother will receive support from a trained Pui Yuet for a period of 12 weeks with 12 hours each week in three home visits, a home assessment by a Registered Nurse during the first home visit, and 4-6 sessions of counselling service by a counsellor during the service period.
The outcomes of the mothers (parenting competency, parental stress, anxiety and depression) will be measured before and after the programme.
Individual semi-structured interviews will be conducted with mothers and Pui Yuet to explore their experiences of and feelings towards the programme after its completion, with audio recording.
Babies’ growth and development will be monitored by reviewing the data on body weight and length before and after completion of the programme, and at the 6-month post-intervention. The attachment between babies and their mothers will be observed during the semi-structured interviews after the programme completion. The medical attendance of babies will also be monitored. The cost-effectiveness of the programme will be estimated with such information.
Recruitment, retention and drop-outs of the trained Pui Yuet, as well as recruitment, compliance and drop-outs of the participating women, will also be monitored.
What are the possible benefits and risks of participating?
The potential benefits of participating in the study include improvements in parenting competency, parental stress, anxiety and postnatal depression among mothers with psychological distress. The interventions are not expected to cause any pain, discomfort, or harm to participants.
Where is the study run from?
Chinese University of Hong Kong (Hong Kong)
When is the study starting and how long is it expected to run for?
March 2025 to April 2027
Who is funding the study?
Yak Tak Charity Fund Limited
Who is the main contact?
Prof Ka Ming Chow, kmchow@cuhk.edu.hk
Contact information
Public, Scientific, Principal Investigator
The Nethersole School of Nursing
6/F, Esther Lee Building
The Chinese University of Hong Kong
Shatin
Hong Kong
NA
Hong Kong
 ORCID ID |
0000-0002-7442-5197 |
|---|---|
| Phone | +852 (0)39434431 |
| kmchow@cuhk.edu.hk |
Study information
| Study design | Non-randomized pilot pre-/post-test quasi-experimental study supplemented by semi-structured individual interviews |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | Community |
| Study type | Other |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | A proactive child protection programme for mothers with psychological distress: an extended project with outcome evaluation |
| Study objectives | 1. Provide an advanced training course for recruited Pui Yuet to act as childcare providers 2. Provide perinatal and childcare support services, by trained Pui Yuet, for poverty families with 0–24-month babies for 3-6 months 3. Provide parenting coaching for mothers in need 4. Provide counselling services for mothers in need 5. Establish a supportive network for mothers living in the district of New Territories East Cluster (NTEC) 6. Evaluate the effects of the proactive child protection programme in terms of maternal, children and Pui Yuet outcomes |
| Ethics approval(s) |
Approved 30/05/2025, Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (8/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong SAR, -, Hong Kong; +852 (0)35053935; crec1@cuhk.edu.hk), ref: 2025.153 |
| Health condition(s) or problem(s) studied | Mothers with psychological distress |
| Intervention | In our pilot study, we developed an 18-hour advanced training course for certified Pui Yuet using six synchronous or pre-recorded online lectures (3 hours each) with a post-training quiz (100% correctness is a prerequisite for completion of the training). The training contents included: 1. Managing mothers with emotional problems/psychological distress 2. Counselling technique 3. Identifying crisis conditions 4. Seeking intervention 5. Getting known with all sorts of available services to support the family 6. Collaborating with a Comprehensive Child Development Surveillance (CCDS) team for medical and social support 7. Advances in child nutrition and child health (physical, psychological and well-being) 8. How to establish a daily routine for infants, including sleep 9. Early childhood development and identification of special educational needs 10. Community service on rehabilitation services for children 11. Parenting techniques and demonstration A total of 45 certified Pui Yuet completed this training and passed the post-quiz. This study will be conducted in two phases. In Phase I, we will recruit more Pui Yuet to join the advanced training course if we need more Pui Yuet to support Phase II of this study. In Phase II, 60 mothers with emotional problems/psychological distress and 0-24-month-old babies will be recruited to attend a 12-week neighbourhood buddies programme. During the programme, each mother will receive support from a trained Pui Yuet (who completed Phase I training) for a period of 12 weeks with 12 hours each week in three home visits, an home assessment by a Registered Nurse during the first home visit, and 4-6 sessions of counselling service by a counsellor during the service period. Please refer to the details below: 1. Medical service: Accompany for medical service, including psychiatric follow-up or Comprehensive Child Development Surveillance (CCDS) assessment of both mothers and their babies 2. Parenting service: Parenting workshop and peer support group 3. Community service: Build up an informal neighbourhood supporting network with medical professionals, where the pui yuet shares updates on the mother’s situation regularly 4. Counselling service: Individual cases might need a counsellor or a family therapist for intervention 5. Pui Yuet service: Perinatal nursery, emotional support, Chinese “po” soup and child care, hopefully can build up a friendship relationship with the family 6. Nursing service: Home safety assessment by a Registered Nurse during the first home visit |
| Intervention type | Behavioural |
| Primary outcome measure | Parental competency measured using the Chinese version of the Parenting Sense of Competence Scale (C-PSOC) at baseline and after the programme |
| Secondary outcome measures | 1. Parental stress of the mothers measured using the Chinese version of Parental Stress Scale (C-PSS) at baseline and after the programme 2. Anxiety of the mothers measured using the Chinese version of State-Trait Anxiety Inventory (C-STAI) at baseline and after the programme 3. Depression of the mothers measured using the Chinese version of Edinburgh Postnatal Depression Scale (C-EPDS) at baseline and after the programme 4. Mothers' and Pui Yuet's experiences of and feelings towards the programme explored by semi-structured interviews after completion of the programme 5. Baby outcomes: Babies’ growth and development will be monitored by reviewing the data of body weight and length before and after completion of the programme, and at the 6-month post-intervention. The attachment between babies and their mothers will be observed during the semi-structured interviews after the programme completion. Medical attendance of babies will also be monitored. Cost-effectiveness of the programme will be estimated with such information. 6. Feasibility outcomes: Recruitment, retention and drop-outs of the trained Pui Yuet, as well as recruitment, compliance and drop-outs of the participating women will also be monitored. |
| Overall study start date | 01/03/2025 |
| Completion date | 30/04/2027 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Adult |
| Sex | Female |
| Target number of participants | 60 mothers |
| Key inclusion criteria | Mothers with emotional problems/psychological distress and 0-24-month-old babies |
| Key exclusion criteria | Does not meet the inclusion criteria |
| Date of first enrolment | 20/06/2025 |
| Date of final enrolment | 31/01/2027 |
Locations
Countries of recruitment
- Hong Kong
Study participating centres
Shatin
Hong Kong
-
Hong Kong
239 Temple Street
Jordan
Hong Kong
-
Hong Kong
Sponsor information
University/education
The Nethersole School of Nursing
6/F, Esther Lee Building
Shatin
Hong Kong
NA
Hong Kong
| Phone | +852 (0)39438174 |
|---|---|
| nursing@cuhk.edu.hk | |
| Website | https://www.nur.cuhk.edu.hk/ |
"ROR" |
https://ror.org/00t33hh48 |
Funders
Funder type
Charity
No information available
Results and Publications
| Intention to publish date | 30/06/2029 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal |
| IPD sharing plan | The datasets generated during and/or analysed during the study will be anonymised and available upon reasonable request from the Chief Investigator Prof Ka Ming Chow (kmchow@cuhk.edu.hk) on a case-by-case basis after publication. Anonymised participant-level data will be available 1 year following completion of the study and for up to 5 years. |
Editorial Notes
16/06/2025: Study's existence confirmed by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee.
