Peer-reviewed article
Effect of home visiting support on maternal psychosocial needs and postnatal depression: emulating a target trial.
Baba K, Narita ZC, Yamasaki S, Shinozaki T, Niimura J et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated the Early Partnership programme, a home visiting intervention co-designed with young mothers aged 16-25 in Tokyo. Young mothers who received intensive home visits from pregnancy through 12 months after birth showed greater improvement in meeting their psychosocial needs and lower symptoms of postnatal depression compared to a control group receiving standard services. The programme was delivered by multi-professional teams and had high retention rates in both groups.
Key points
- Intervention group showed greater improvement in perceived fulfilment of psychosocial needs at 6 months (difference 4.16, Cohen's d 0.40) and 12 months postnatally (difference 3.93, Cohen's d 0.39)
- Postnatal depressive symptoms were lower in the intervention group at 6 months (mean difference -1.54) and 12 months (mean difference -1.55)
- High retention rates in both intervention (82.1%) and control (82.9%) groups at 12 months
- The programme was co-designed with first-time young mothers and grounded in their lived experiences
- Multi-professional family support workers delivered tailored home visits from pregnancy to 12 months postnatally
Limitations
The study uses a historically controlled design rather than a randomised controlled trial, which may introduce bias. The findings are specific to Tokyo municipalities and may not generalise to other settings or countries with different healthcare systems.
Abstract
Background Adolescent and young adult (AYA) mothers often experience unmet psychosocial needs, and those under 25 years of age are at increased risk of perinatal depression. Although home visiting programmes may be beneficial, no controlled trial has evaluated a programme co-designed with first-time AYA mothers and grounded in their lived experiences. Objective We evaluated the effect of the co-designed Early Partnership programme on perceived fulfilment of psychosocial needs and postnatal depressive symptoms among first-time AYA mothers. Methods We emulated a target trial using data from a pragmatic historically controlled study in four Tokyo municipalities. Participants were primiparous women aged 16-25 years. The intervention group included 151 participants and the control group included 158 participants. The intervention group received intensive tailored home visits by multi-professional family support workers from pregnancy to 12 months postnatally, and the historical control group received publicly funded health and social services. Findings Retention at 12 months was high in both groups (intervention group, 82.1%; control group, 82.9%). For the primary outcome analysis, the intervention group had greater improvement in perceived fulfilment of psychosocial needs at 6 months postnatally (difference in mean changes 4.16, 95% CI 1.35 to 6.97, Cohen's d 0.40, 95% CI 0.13 to 0.67) and 12 months postnatally (difference in mean changes 3.93, 95% CI 0.63 to 7.23, Cohen's d 0.39, 95% CI 0.06 to 0.72) than the control group. Postnatal depressive symptoms were lower in the intervention group at 6 months postnatally (mean difference -1.54, 95% CI -2.70 to -0.38, Cohen's d -0.34, 95% CI -0.59 to -0.08) and 12 months postnatally (mean difference -1.55, 95% CI -2.74 to -0.36, Cohen's d -0.34, 95% CI -0.61 to -0.07). Well-being also improved at each time point, but estimates were imprecise. Conclusions The Early Partnership programme, co-designed with young mothers and delivered by multi-professional teams, was acceptable and effective in improving perceived fulfilment of psychosocial needs and postnatal depressive symptoms. Clinical implications These findings suggest that a person-centred and relationship-based home visiting model, delivered through a non-stigmatising design, may represent a plausible model of maternal care.