Kelli MacMillan

INTRODUCTION: Adverse childbirth experience has been increasingly recognised as a risk factor for perinatal mental health problems including post-traumatic stress disorder, depression, anxiety, and adjustment disorder. Conversely, positive childbirth experience is a predictor of increased maternal self-efficacy a protective factor for child development and parenting capacity. With around 310,000 births each year in Australia, including live births and stillbirths, access to effective intervention to improve the experience of childbirth is an important public health issue. Yet, there is an absence of accessible and cost-effective intervention for women at risk of adverse childbirth experience.

AIM: This study is designed to identify the maternal and infant characteristics of women accessing Sensitive Care Birth Plans (SCBP) at King Edward Memorial Hospital (KEMH) in Western Australia. SCBP are the product of a collaborative process between the patient and the clinician in the context of antenatal psychological treatment at the Department of Psychological Medicine. While there is anecdotal evidence of the utility of SCBPs, we first aim to better understand their clinical application by characterising the clinical profile of the women accessing them, with a secondary aim of facilitating future assessment of the effectiveness of this intervention, as well as providing a description of SCBP for application to other service settings.

METHODS: Data will be drawn from 115 patient files identified with SCBPs between 2022 and 2023 at KEMH. Key maternal and infant factors will be identified to inform an understanding of the characteristics of the women accessing this intervention.

CONCLUSION: By understanding the profile of women receiving SCBPs, this study may inform a future pilot designed to assess the effectiveness of this antenatal intervention. This intervention has the potential to provide a model for other services of equitable and effective antenatal intervention to enhance early maternal and infant outcomes in the context of childbirth.

Introduction: Reviews have indicated that community-based interventions targeting infant sleep can be effective. However, the literature is less clear as to the theoretical underpinnings and active components of infant sleep interventions, whether these are related to parental measures, such as acceptability, adherence, satisfaction and mood, and whether certain characteristics of interventions are associated with greater effectiveness on sleep measures.

Aim: This review broadly aimed to characterise behavioural infant sleep interventions delivered in a community setting in terms of theoretical underpinnings and behaviour change techniques. Where applicable, this review also aimed to explore associations between meaningful groupings of theory type (e.g., operant conditioning and extinction; attachment theory) and behaviour change techniques and secondary outcomes including parent and infant sleep, parent satisfaction and intervention adherence.

Method: Online databases were searched from inception to October 2022 to identify Randomised Controlled and cluster Randomised Controlled Trials of behavioural interventions delivered in community settings that targeted the prevention or treatment of sleep problems in infants (0-3 years). Using the PRISMA guidelines, records were independently screened by two reviewers and eligible interventions were coded for the presence and type of theoretical underpinnings used. Active components were also coded using a taxonomy for behaviour change techniques. The role of secondary outcomes, such as intervention feasibility and parent satisfaction, were also explored.

Conclusions: This systematic review elucidates the specific components used by behavioural infant sleep interventions and the theories that are drawn upon to inform intervention development. This study concludes with a discussion of how obtained results may aid in the development of community based infant sleep support, such as the consideration around which behaviour change components to utilise when addressing particular outcomes. Implications for selection of theoretical underpinnings in intervention development on parent outcomes are also explored.