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The CRADLE (Community-enabled Readiness-for-1000-Days Learning Ecosystem) initiative seeks to improve first-time families' self-efficacy in parenting and to tangibly impact factors in maternal and child care which will result in improved health of mother and child.
Title: CRADLE (Community enabled Readiness for first 1000-Days Learning Ecosystem) Project
Introduction:
The "developmental origins of health and disease" (DOHaD) is a concept that has emerged over the past 50 years, linking the state of health and risk from disease in early childhood and adult life. With increasing evidence in neuroscience of the critical window of the first 1000 days of life which has life- long impact on cognitive, behavioral, physical and mental health of an individual. In present society where new parents learned the skills from social media which are based on personal perception and not evidence.
CRADLE (Community-enabled Readiness-for-1000-Days Learning Ecosystem) initiative seeks to improve first-time families' self-efficacy in parenting and to tangibly impact factors in maternal and child care which will result in improved health of mother and child.
Hypothesis:
Use of an integrated choice architecture in a self-learning eco-community, with calibrated nudges, and group interactions & interaction with midwives and individualised teleconferencing sessions in the first 1000-days for first-time families will improve parenting self-efficacy.
Method:
This will be an Interventional Cohort Study. Each ARM 250 subjects. ARM 1 : Routine care ARM 2 : Behavioral Intervention with nudges and Facebook interaction ARM 3 : Community Intervention with interaction with midwives and individualised teleconferencing sessions
The follow up period will be from first contact till child reaches 2 years old Measurement.
The investigators will quantify the impact of this initiative through measurements of specific health & nutrition domains & patient-reported outcome measures (see below) as well as participant satisfaction.
The two key health morbidities the investigators are addressing are the overall health and mental wellness of first-time families as well as their metabolic health (ie, nutrition).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: Routine Care | No Intervention | Participants will undergo routine care but take part in assessments. | |
| Arm 2:Behavioral Intervention with nudges & Facebook | Active Comparator | Participants will receive nudges and be enrolled in social media platform. |
|
| Arm 3: Community Intervention with individualised teleconferencing sessions and phone calls. | Active Comparator | Participants will receive individualised teleconferencing sessions and phone calls by skilled midwives. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Arm 2:Behavioral Intervention with nudges & Facebook interaction | Behavioral | Participants will receive nudges and be enrolled to Facebook group for self-learning. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Parenting self-efficacy | Parenting self-efficacy as assessed by the Tool to measure Parenting Self-Efficacy, which is domain-specific. | Up to 24 months of age, from 6 weeks after birth until 24 months of age |
| Parenting self-efficacy | Parenting self-efficacy as assessed by the Parental Sense of Competence Scale, which is domain-general. | Up to 24 months of age, from 6 weeks after birth until 24 months of age |
| Measure | Description | Time Frame |
|---|---|---|
| Health experience | Health Experience as assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global10. | Up to 18 months of age, from first trimester in pregnancy until 18 months during the postnatal period |
| Birth experience |
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Inclusion Criteria:
Exclusion Criteria:
1. Has existing medical conditions such as chronic illnesses
First-time mothers
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kee Chong Ng, MMed | Contact | 63942301 | ng.kee.chong@singhealth.com.sg | |
| Joyce Teo, BBus | Contact | 63947137 | joyce.teo.xy@kkh.com.sg |
| Name | Affiliation | Role |
|---|---|---|
| Kee Chong Ng, MMed | KK Women's and Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| KK Women's and Children's Hospital | Recruiting | Singapore | 229899 | Singapore |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33676560 | Derived | Loy SL, Thilagamangai, Teo J, Chan SW, Razak NKA, Chay OM, Ng KC. A Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) for first-time families: study protocol of a three-arm randomised controlled trial. Trials. 2021 Mar 6;22(1):191. doi: 10.1186/s13063-021-05144-5. |
| Label | URL |
|---|---|
| PROMIS GLOBAL HEALTH | View source |
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Access to IPD will be limited to the project study team only.
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Interventional study design
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| Arm 3: Community Intervention with individualised teleconferencing sessions and phone calls. | Other | Participants will receive individualised teleconferencing sessions and phone calls by skilled midwives. |
|
Birth Experience as assessed by the Birth Satisfaction Scale - Revised. |
| At point of birth |
| Mental wellness | Mental wellness as assessed by the Patient Health Questionnaire-2. | Up to 6 months of age, from first trimester in pregnancy up to 6 months during postnatal period |
| Depressive symptoms | Depressive symptoms as assessed by the Edinburg Postnatal Depression Scale (EPDS). | Up to 6 months of age, from first trimester in pregnancy up to 6 months during postnatal period |
| Maternal nutritional status | Maternal nutritional status as assessed based on weight status, i.e. weight gain and weight retention. | Through study completion, from first trimester in pregnancy up to 24 months during postnatal period |
| Child nutritional status | Child nutritional status as assessed based on weight and height. | From birth until up to 24 months during postnatal period |
| Breastfeeding self-efficacy | Breastfeeding self-efficacy as assessed by the Breastfeeding Self-Efficacy Score-Short Form. | From birth until up to 6 months during postnatal period |
| Maternal feeding beliefs and practices | Maternal feeding beliefs and practices as assessed by the Infant Feeding Questionnaire. | At 18 months of age, at 18 months during postnatal period |
| THE PATIENT HEALTH QUESTIONAIRE-2 (PHQ-2) | View source |
| EDINBURGH POSTNATAL DEPRESSION SCALE (EPDS) | View source |
| PARENTAL SENSE OF COMPETENCY SCALE (PSOC) | View source |
| TOPSE Tool to measure Parenting Self-Efficacy | View source |
| BREASTFEEDING SELF-EFFICACY SCORE- SHORT FORM | View source |
| BIRTH SATISFACTION SCALE-REVISED | View source |
| INFANT FEEDING QUESTIONNAIRE | View source |