TY - JOUR AU - Kavanagh, David John AU - Connolly, Jennifer AU - Fisher, Jane AU - Halford, W Kim AU - Hamilton, Kyra AU - Hides, Leanne AU - Milgrom, Jeannette AU - Rowe, Heather AU - Scuffham, Paul A AU - White, Katherine M AU - Wittkowski, Anja AU - Appleton, Shelley AU - Sanders, Davina PY - 2021 DA - 201/11/26 TI -新生儿父母幸福的婴儿步骤网络计划:随机对照试验JO - J医学互联网Res SP - e23659 VL - 23is - 11 KW -围产期KW -抑郁KW -预防KW -男性KW -自我引导KW -互联网AB -背景:初为父母面临情绪困扰和关系不满的风险增加。数字干预增加了支持的获取，但很少有针对父母双方优化的预防方案。目的:本研究旨在开展首个关于通用自我引导数字程序的随机对照试验，以支持母亲和父亲积极的围产期调整。比较了儿童保育信息(婴儿护理)和信息加互动项目(婴儿步健康)的效果，从妊娠晚期基线到随后的3个月和6个月。方法:该研究招募了388对共同抚养的、期待第一个孩子(怀孕26-38周)的成年男女夫妇，使用网络注册。大多数(337/388,86.8%)来自产前医院班。夫妻的随机化采用爱丁堡产后抑郁量表(EPDS)评分自动分层(如果母亲>7，父亲>5,50%的夫妇得分高)。所有评估都是基于网络的自我报告:EPDS和社会心理生活质量是主要结果;关系满意度，社会支持，自我效能感的养育和支持提供是次要的。 Linear mixed models provided intention-to-treat analyses, with linear and quadratic effects for time and random intercepts for participants and couples. Results: Selection criteria were met by 63.9% (248/388) of couples, who were all randomized. Most participants were married (400/496, 80.6%), tertiary educated (324/496, 65.3%), employed full time (407/496, 82%), and born in Australia (337/496, 67.9%). Their mean age was 32.2 years, and average gestation was 30.8 weeks. Using an EPDS cutoff score of 13, 6.9% (18/248) of men, and 16.1% (40/248) of women screened positive for depression at some time during the 6 months. Retention of both partners was 80.6% (201/248) at the 6-month assessments, and satisfaction with both programs was strong (92% ≥50). Only 37.3% (185/496) of participants accessed their program more than once, with higher rates for mothers (133/248, 53.6%) than fathers (52/248, 20.9%; P<.001). The EPDS, quality of life, and social support did not show differential improvements between programs, but Baby Steps Wellbeing gave a greater linear increase in self-efficacy for support provision (P=.01; Cohen d=0.26) and lower reduction in relationship satisfaction (P=.03; Cohen d=0.20) than Baby Care alone. Mothers had greater linear benefits in parenting self-efficacy over time than fathers after receiving Baby Steps Wellbeing rather than Baby Care (P=.01; Cohen d=0.51). However, the inclusion of program type in analyses on parenting self-efficacy and relationship satisfaction did not improve model fit above analyses with only parent gender and time. Conclusions: Three secondary outcomes showed differential benefits from Baby Steps Wellbeing, but for one (parenting self-efficacy), the effect only occurred for mothers, perhaps reflecting their greater program use. Increased engagement will be needed for more definitive testing of the potential benefits of Baby StepsWellbeing for perinatal adjustment. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12614001256662; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367277 SN - 1438-8871 UR - //www.mybigtv.com/2021/11/e23659 UR - https://doi.org/10.2196/23659 UR - http://www.ncbi.nlm.nih.gov/pubmed/34842534 DO - 10.2196/23659 ID - info:doi/10.2196/23659 ER -