Browsing by Author "Kingston, Dawn"

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    Effect of maternal mental health improvement programs on obesity in pediatric populations: a protocol for a systematic review and meta-analysis
    (2018-08-29) Wajid, Abdul; Mughal, Muhammad K; McNeil, Deborah; Robertson, Helen L; Kingston, Dawn
    Abstract Background Childhood obesity has become a global epidemic irrespective of the socioeconomic status of a country or nation. Obesity increases the risk of various diseases in children, for example asthma, sleep apnea, bone and joint problems, type-2 diabetes, and heart problems. The existing literature informs us of the many factors associated with childhood obesity. Among these factors, maternal mental health has been found to be a strong predictor. Maternal mental health programs were implemented to address the issue of childhood obesity but with little or no improvement. It suggests systematically reviewing the literature to assess the contents of these programs and carrying out meta-analysis for the overall effect of these interventions. Methods The studies included in this review will be experimental designs such as randomized controlled trials (RCTs) which provide information on interventions to improve maternal mental health and its effects on childhood obesity. We plan to search MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, ERIC, CINAHL, ProQuest Dissertations and Theses Global, Scopus, and Web of Science with no restrictions as to language. Reference lists of the selected articles will also be searched for additional articles. The Cochrane EPOC Risk of Bias Tool will be used to assess the quality of studies. If the studies lend themselves to a statistical analysis, we will also carry out a meta-analysis. Discussion This review will help determine the effect of maternal health improvement programs on childhood obesity. These findings, in turn, will guide the research community on the development of related programs in the future. Systematic review registration PROSPERO: CRD42017072737 .
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    Effectiveness of psychotherapeutic interventions on psychological distress in women who have experienced perinatal loss: a systematic review protocol
    (2020-06-02) Charrois, Elyse M; Bright, Katherine S; Wajid, Abdul; Mughal, Muhammad K; Hayden, K. A; Kingston, Dawn
    Abstract Background Perinatal loss is a traumatic and complex experience that contributes to negative maternal psychological states and adverse outcomes impacting fetal development, maternal-fetal/infant bonding, marital/partner relationships, and child cognitive, emotional, and behavioral development. These outcomes present preventable disease burden and financial liability to individuals, families, and the healthcare system. Psychological interventions have the potential to improve outcomes for women and their families after perinatal loss. A few studies have explored the effectiveness of individual psychotherapeutic interventions in reducing maternal psychological distress after perinatal loss; however, a systematic review to compare these interventions has not been conducted. The primary objective of this systematic review is to determine the effectiveness of psychotherapeutic intervention on psychological distress and perception, coping, and adjustment in women who have experienced perinatal loss. The secondary objective of this review is to examine the content and delivery methods of effective psychotherapeutic interventions. Methods We endeavor to search electronic databases (PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, CINAHL, Social Work Abstracts, Family and Society Studies Worldwide, Family Studies Abstracts, Academic Search Premier), gray literature databases (Proquest Dissertation and Theses Global, Web of Science Conference Proceedings Citation Index, OAIster, Open-Grey, Canadian Electronic Library, Canadian Research Index), and relevant organizational websites and conduct forward and backward citation searches of included studies. Inclusion criteria will consider studies that (1) are randomized controlled trials (RCTs), quasi-experimental (e.g., before-after design), and observational (prospective cohort); (2) include women affected by perinatal loss accessing psychotherapeutic intervention or support; and (3) evaluate a mental health or related outcome. Two authors will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. The primary outcome(s) will be measurements on the severity of depressive, anxiety, grief, and post-traumatic stress symptoms. Secondary outcomes will include measurements on difficulties in perception, coping, social, or dyadic adjustment. Conducting a narrative synthesis will identify relationships within study findings, and if appropriate, a random effects meta-analysis will be performed. Discussion This systematic review will summarize the effectiveness of psychological interventions, including their content and delivery method, in reducing psychological distress and improving outcomes for women affected by perinatal loss. The evidence generated from this review can inform researchers and policymakers in expanding on related research and developing customized interventions or programs. Systematic review registration PROSPERO CRD42019126456.
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    Factors Affecting Parental Help seeking for Children with Mental Health Problems
    (2017) Harvalik, Paula; Kingston, Dawn; Arnold, Paul; McDonald, Sheila; Goldsworthy, Sandra
    Background. Childhood mental health problems have an early onset, are highly prevalent, and persistent into adolescents’ and adulthood, and left untreated, mental health problems are exacerbated by comorbid disorders. Early screening and intervention for childhood mental health is key to improved outcomes. Very young children that experience emotional or behavioural problems rely primarily on their parents for help-seeking on their behalf. Parents often do not recognize problematic behaviour that requires further evaluation and treatment. Without parental help-seeking, these children’s mental health problems remain undetected and untreated throughout the lifespan. Understanding what perceived barriers and facilitators exist for parents that have children with problematic behaviours, can inform the development of early intervention programs aimed at very young children (i.e., 5 years old and under). The aim of this thesis by publication was to examine the barriers and facilitators to help-seeking for parents with children that have emotional and behavioural problems. Methods. Two published studies of perceived barriers and facilitators to help-seeking for parents of young children were identified through searches using PubMed, PsycINFO, Embase, and CINAHL databases. Data was extracted and summarized in tables. Results. Parents reported perceived barriers to be: (a) child’s problems being identified as transient and part of a stage that will go way on their own, (b) not knowing what services were available, and (c) not knowing what sources were available for help. Conclusions. Increased research and development of early screening and intervention programs that target parents of very young children will improve mental health outcomes for children, their families, and communities.
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    Identifying Effective Psychotherapeutic Interventions and Preferences in Emotional Care: Reducing Psychological Distress and Promoting Emotional Health in Women who have Experienced Perinatal Loss
    (2022-01-26) Charrois, Elyse Mireille; Kingston, Dawn; Giallo, Rebecca; Dimitropoulos, Gina
    Perinatal loss is a challenging experience because of the unexpected nature through which the loss of an unborn or recently born child commonly occurs. At present, evidence-based interventions to support women affected by perinatal loss are scarce. Understanding psychological distress after perinatal loss and identifying effective psychotherapeutic interventions and preferences in emotional care will likely improve emotional health for women across time. The purpose of this doctoral thesis is to provide the evidence needed to inform the development of, and improve women’s access to, a universal, integrated emotional health screening, referral and intervention initiative that is responsive to the needs of women who have experienced perinatal loss. This thesis contains a secondary data analysis (Chapter 2), a systematic review protocol (Chapter 3), a systematic review and meta-analysis (Chapter 4), and a cross-sectional descriptive survey (Chapter 5). The secondary analysis examined the trajectory patterns of depressive and anxiety symptoms following miscarriage and stillbirth from early pregnancy up to when the mother’s child was 11 years old and identified early factors predictive of elevated symptom trajectory patterns. This is the first latent class analysis to identify longitudinal symptom trajectories and early factors predictive of elevated trajectories. The review and meta-analysis analysed and synthesized research evaluating the effectiveness of psychotherapeutic interventions to treat or decrease psychological distress in women after perinatal loss and outlined the content and delivery method of effective interventions. This is the first review to identify effective psychotherapeutic interventions and summarize their characteristics. The survey study explored women’s perception of the barriers and facilitators in discussing their emotional health with a healthcare provider after prenatal loss and identified their preferences in emotional care. This is the first study to identify women’s influences and preferences in accessing emotional care surrounding a pandemic. In summary, the studies within this research program provide evidence needed to develop a universal, integrated screening, referral and intervention initiative. This initiative empowers women to monitor and manage their emotional health after a perinatal loss. By engaging in discussions related to emotional health, healthcare providers facilitate women’s early access to resources and improve their emotional health.
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    Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial
    (2019-12-30) Bright, Katherine S; Mughal, Muhammad K; Wajid, Abdul; Lane-Smith, Marie; Murray, Lindsay; Roy, Nicola; Van Zanten, Sander V; Mcneil, Deborah A; Stuart, Scott; Kingston, Dawn
    Abstract Background Psychological distress, defined as depression, anxiety and perceived stress, during pregnancy is common, with 15–25% of women experiencing clinically significant levels of such distress. Despite the far-reaching impact of prenatal psychological distress on mothers and their children, and that women are receptive to screening, few providers routinely screen for prenatal psychological distress and less than one in five women will receive the mental health care that they require. There is a lack of certainty regarding the most effective treatments for prenatal psychological distress. No online interpersonal psychotherapy (IPT) trials have been conducted that focus on improving psychological distress in prenatal women. The purpose of this pilot randomized controlled trial is to evaluate the perspectives of pregnant women on the feasibility and acceptability of online IPT (e-IPT) delivered during pregnancy. Methods A pilot randomized controlled trial design with repeated measures will evaluate the feasibility and acceptability of e-IPT for pregnant women compared to routine prenatal care. Qualitative interviews with 15–30 individuals in the intervention group will provide further data on the feasibility and acceptability of the intervention. Assessment of feasibility will include the ease of accessing and completing the intervention. Women will also be asked about what barriers there were to starting and completing the e-IPT. Assessment of acceptability will inquire about the perception of women regarding the intervention and its various features. A sample size of 160 consenting pregnant women aged 18 years and older will be enrolled and randomized into the experimental (e-IPT) or control (routine care) condition. The secondary outcome measures include: depression, anxiety and stress symptoms; self-efficacy; self-mastery; self-esteem; relationship quality (spouse, immediate family members); coping; and resilience. All participants will complete the aforementioned measures at baseline during pregnancy (T1), 3 months postrandomization (T2), at 8 months of pregnancy (T3), and 3 months postpartum (T4). Discussion The results of this pilot randomized controlled trial will provide data on the feasibility and acceptability of the intervention and identify necessary adaptations. This study will allow for optimization of full trial processes and inform the evaluation strategy, including sample size calculations for the full randomized controlled trial. Trial registration ClinicalTrials.gov, NCT01901796. Registered on 18 December 2014.
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    Interpersonal psychotherapy for perinatal women: a systematic review and meta-analysis protocol
    (2019-10-29) Bright, Katherine S; Charrois, Elyse M; Mughal, Muhammad K; Wajid, Abdul; McNeil, Deborah; Stuart, Scott; Hayden, K. A; Kingston, Dawn
    Abstract Background Interpersonal psychotherapy (IPT) is an intervention that has established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of well-being. There is limited data regarding factors that moderate and mediate the effectiveness of IPT including the timing of the intervention or the mode of delivery of IPT intervention. The objective of this systematic review and meta-analysis is to evaluate the effectiveness, feasibility, and acceptability of IPT interventions to treat perinatal psychological distress and to summarize the evidence on predictors, mediators, and moderators of IPT. Methods We will include peer-reviewed studies that recruited perinatal women. The search strategy will involve the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO), and Scopus. Study inclusion criteria include (1) randomized controlled trials, quasi-experimental studies, and pre-post studies that evaluated the effectiveness of IPT; (2) qualitative studies that evaluated feasibility and acceptability of IPT; (3) study sample included and analyzed perinatal women; and (4) publication language was English. Using pilot-tested screening and data extraction forms, two reviewers will independently review studies in three steps: (1) abstract/title screening, (2) full-text screening of potentially accepted studies, and (3) data extraction of accepted studies. Disagreements will be resolved by a third reviewer. Studies will be aggregated for meta-synthesis and meta-analysis should the data allow for this. Two independent reviewers will grade methodological quality. Discussion Findings from this review will inform future development and implementation of IPT intervention research for perinatal women. Identifying key factors of successful IPT interventions will inform intervention design and adaptation of IPT interventions to increase the likelihood that perinatal women will engage in and benefit from IPT interventions. This review will also identify key considerations for increasing the effectiveness of IPT interventions during the perinatal period. Systematic review registration PROSPERO CRD42019114292
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    Predictors of child resilience in a community-based cohort facing flood as natural disaster
    (2020-11-19) Arshad, Muhammad; Mughal, Muhammad K; Giallo, Rebecca; Kingston, Dawn
    Abstract Background Natural disasters are unpredictable and uncontrollable events that usually induce significant level of stress and social disruption in afflicted individuals. The consequences are formidable, affecting lifetime health and economic prosperity. Among natural disasters, floods are the most common causes and tend to have the highest economic burden. The aim of this study was to examine factors associated with child resilience in the face of the natural disaster experienced by the city of Calgary, Alberta, Canada during its unprecedented flood of 2013. Methods The current study was conducted in a community-based cohort situated in the city of Calgary. The participants were recruited out of the All Our Families longitudinal cohort within the Cummings School of Medicine at the University of Calgary. Of the total 1711 people contacted, 469 people consented and completed questionnaire. Of those 469 who consented to be part of the study, 467 were eligible to be included for analysis. A flood impact questionnaire was delivered 6 months after the 2013 flood in families whose children were an average of 3 years old. Mother reported questionnaires were used to assess child resilience. The study included maternal data on a range of factors including socio-demographic, history of mental health, relationship with the partner and social support. Child related data were also incorporated into the study, and variables included delivery mode, child sex, and child age at the time of disaster. Results Child resilience was best predicted by mother’s age and social support, and by child gender, the child’s externalizing and internalizing behaviors and the Rothbart temperament scale: effortful control. Furthermore, this study revealed that children who were more exposed to the flood events, showed higher resilience compared to the children who were less or not exposed. Conclusions These findings highlight the risk and protective factors that predict child resilience and suggest that mother reported questionnaire are useful tools to assess child resilience amidst early life adversity.
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    Shared decision making in pregnancy in inflammatory bowel disease: design of a patient orientated decision aid
    (2021-07-30) Williams, Astrid-Jane; Karimi, Neda; Chari, Radha; Connor, Susan; De Vera, Mary A.; Dieleman, Levinus A.; Hansen, Tawnya; Ismond, Kathleen; Khurana, Rshmi; Kingston, Dawn; O’Connor, Katie; Sadowski, Daniel C.; Fang-Hwa, Flora; Wine, Eytan; Leung, Yvette; Huang, Vivian
    Abstract Background Research has indicated a lack of disease-specific reproductive knowledge among patients with Inflammatory Bowel Disease (IBD) and this has been associated with increased “voluntary childlessness”. Furthermore, a lack of knowledge may contribute to inappropriate medication changes during or after pregnancy. Decision aids have been shown to support decision making in pregnancy as well as in multiple other chronic diseases. A published decision aid for pregnancy in IBD has not been identified, despite the benefit of pre-conception counselling and patient desire for a decision support tool. This study aimed to develop and test the feasibility of a decision aid encompassing reproductive decisions in the setting of IBD. Methods The International Patient Decision Aid Standards were implemented in the development of the Pregnancy in IBD Decision Aid (PIDA). A multi-disciplinary steering committee was formed. Patient and clinician focus groups were conducted to explore themes of importance in the reproductive decision-making processes in IBD. A PIDA prototype was designed; patient interviews were conducted to obtain further insight into patient perspectives and to test the prototype for feasibility. Results Issues considered of importance to patients and clinicians encountering decisions regarding pregnancy in the setting of IBD included fertility, conception timing, inheritance, medications, infant health, impact of surgery, contraception, nutrition and breastfeeding. Emphasis was placed on the provision of preconception counselling early in the disease course. Decisions relating to conception and medications were chosen as the current focus of PIDA, however content inclusion was broad to support use across preconception, pregnancy and post-partum phases. Favourable and constructive user feedback was received. Conclusions The novel development of a decision aid for use in pregnancy and IBD was supported by initial user testing.
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    Study protocol for a comparative effectiveness trial of two models of perinatal integrated psychosocial assessment: the PIPA project
    (2017-07-20) Reilly, Nicole; Black, Emma; Chambers, Georgina M; Schmied, Virginia; Matthey, Stephen; Farrell, Josephine; Kingston, Dawn; Bisits, Andrew; Austin, Marie-Paule
    Abstract Background Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psychosocial assessment occurs or how broader components of integrated care, including clinician decision-making aids, may optimise program delivery and its cost-effectiveness. There is also limited evidence relating to the diagnostic accuracy of symptom-based screening measures used in this context. The Perinatal Integrated Psychosocial Assessment (PIPA) Project was developed to address these knowledge gaps. The primary aims of the PIPA Project are to examine the clinical- and cost-effectiveness of two alternative models of integrated psychosocial care during pregnancy: ‘care as usual’ (the SAFE START model) and an alternative model (the PIPA model). The acceptability and perceived benefit of each model of care from the perspective of both pregnant women and their healthcare providers will also be assessed. Our secondary aim is to examine the psychometric properties of a number of symptom-based screening tools for depression and anxiety when used in pregnancy. Methods This is a comparative-effectiveness study comparing ‘care as usual’ to an alternative model sequentially over two 12-month periods. Data will be collected from women at Time 1 (initial antenatal psychosocial assessment), Time 2 (2-weeks after Time 1) and from clinicians at Time 3 for each condition. Primary aims will be evaluated using a between-groups design, and the secondary aim using a within group design. Discussion The PIPA Project will provide evidence relating to the clinical- and cost- effectiveness of psychosocial assessment integrated with electronic clinician decision making prompts, and referral options that are tailored to the woman’s psychosocial risk, in the maternity care setting. It will also address research recommendations from the Australian (2011) and NICE (2015) Clinical Practice Guidelines. Trial Registration ACTRN12617000932369