BOOST-3: Boosting baby communication and play

Plain English summary of protocol

Background and study aims
When a mother or birthing person (MABP) experiences mental illness in the first two years of their child's life, this is known as perinatal mental illness. It can sometimes affect their confidence in their parenting ability, lead to difficulties in feeling a bond with their child, and lead to difficulties in understanding and responding to their child's communication (known as sensitivity difficulties). This can be distressing for parents and something they want support with. Addressing these early difficulties in parent-child relationships can potentially improve children's future mental health and social outcomes. However, we have no robust evidence on what helps to support positive parent-child relationships and child mental health specifically for mothers and birthing persons experiencing severe or complex perinatal mental illness. They are likely to need tailored support due to feeling self-critical about their parenting and worrying about being judged. The video feedback intervention for positive parenting (VIPP) involves videoing parents interacting with their children. Parents are given positive and strengths-focussed feedback to help them understand and respond to what their child is communicating ( sensitivity) and to help them feel confident in their parenting abilities and in their bond with their child. Previous research has definitively shown that VIPP supports sensitive parent-child interactions and boosts child mental health in other vulnerable groups, such as parents with adopted children. However, we do not yet know if VIPP is helpful for mothers and birthing persons experiencing severe or complex perinatal mental illness. Our team has adapted VIPP to help mothers and birthing persons (MABP) experiencing severe or complex perinatal mental illness manage self-critical feelings and worries about being judged (VIPP-PMH). We found that MABP receiving VIPP-PMH felt more confident and were twice as likely to respond sensitively to their child's communication. But we could not be sure this was due to VIPP-PMH as the studies were small. We will now carry out a larger study to work out if VIPP-PMH really is helpful for this group of parents and their children.

Who can participate?
We will evaluate VIPP-PMH in 258 MABP experiencing moderate to severe or complex perinatal mental illness, who have a child aged 3 to 12 months old, and who are experiencing difficulties in their relationship with their child.

What does the study involve?
Half of the MABP will receive VIPP-PMH alongside perinatal mental health care, whilst the other half will receive perinatal mental health care alone. Who gets what will be decided at random.
1. We will evaluate whether VIPP-PMH is superior to perinatal mental health care alone in a) supporting MABPs' positive responses to their child's communication ( sensitivity ) and b) boosting their child's mental health. We will assess this using questionnaires and videos of them playing with their child.
2. We will also test whether VIPP-PMH is more helpful for some groups of MABPs than others, so we can ensure it is offered to the parents and children who will benefit the most in the future (targeting).
3. Finally, we will test whether one of the ways in which VIPP-PMH works to improve sensitivity and children's mental health is through improving c) MABPs' parenting confidence and d) their bond with their child (mediators)

What are the possible benefits and risks of participating?
We are in the early stages of this research and therefore we cannot say with certainty that taking part will be of benefit. However, the Baby Communication and Play sessions have been used in research studies previously and parents have found them helpful. Afterwards, participants will be able to download your own copy of the clips of baby and you playing together. The disadvantages of taking part are likely to be small. Participants will need to put some time aside for the research visits, and for whichever type of support you are allocated to receive (e.g. the Communication & Play visits). Answering questionnaires may bring up unhappy feelings. Some people can find it awkward to be filmed or to watch clips of themselves, and can start to feel self-conscious, judge themselves or worry that others will judge them. We have found people usually relax after the first session and when they realise they are not being judged. The professionals conducting the visits are specially trained to be aware of this and to help participants deal with these feelings.

Where is the study run from?
The study is led by researchers at City St George's, University of London. Local mental health and research teams are taking part all across England.

When is the study starting and how long is it expected to run for?
The study will open for new participants in December 2026 and is currently planned to stop recruiting participants in November 2028.

Who is funding the study?
The National Institute for Health and Social Care Research (UK)

Who is the main contact?
Una Hutton Una.hutton.3@city.ac.uk

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• United Kingdom
• England

Study participating centre

Results and Publications

Editorial Notes

12/06/2026: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).