Can a community-led intervention offering social support and health education improve maternal health?: a repeated measures evaluation of the PACT project run in a socially deprived London borough at 6 month follow-up

Abstract Background Social adversity can significantly influence the wellbeing of mothers and their children. Maternal health may be improved through strengthened support networks and better health literacy. Population level health improvement requires the optimizing of the collaboration between statutory services (e.g. midwifery and health visiting services), civic organisations (e.g. churches, schools) as well as community groups and parents themselves. Key elements in improving community engagement are co-production and community control. This study evaluates a co-produced and community-led intervention developed for ante-natal and post-natal mothers, offering social support and health education. The intervention was based in a deprived south London borough. Methods A pre-post design was used to assess changes in the maternal health of mothers before and 6 months after attending a weekly intervention offering two key elements: social support for mothers and children (called Mumspace), and health education for mothers (called Parent University). Measures used included depression (PHQ-9), anxiety (GAD-7), health literacy (New Vital Signs), social capital (ASSIS) and a satisfaction measure. Results Sixty-one mothers were recruited at baseline and 58 mothers (95.1%) followed up after 6 months. The PACT intervention attracted some “difficult to engage” mothers, specifically Nigerian (26.2%) and Latin American (9.8%) mothers, the proportion of which was 5.8% and 3.6% above that in census records. Significant improvements were found on depression and anxiety for all the mothers, but particularly significant changes were found for those with more severe problems at baseline. There were also improvements in health literacy for those with poor literacy at baseline, overall social capital as well as 4 out of the 8 specific aspects. Satisfaction with the service was high. Conclusions This community-led social support and health education intervention has engaged “difficult to engage” mothers, as well as found very positive outcomes from a 6 month follow-up of mothers. Improvements were found on mental health, with particularly marked changes in depression and anxiety of mothers with more severe problems. Improvements in health literacy and social capital were also found. This is a promising intervention for the maternal mental health of mothers. A more rigorous controlled trial is recommended to further examine its effectiveness.