A RCT of peer-mentoring for first-time mothers in socially disadvantaged areas (the MOMENTS Study).
OBJECTIVE
Interventions to reduce health inequalities for young children and their mothers are important: involving peers is recommended, but evidence of value for this approach is limited. The authors aimed to examine the effect of an innovative tailored peer-mentoring programme, based on perceived needs, for first-time mothers in socio-economically deprived communities.


METHODS
Randomised controlled trial; parallel qualitative study with purposive samples using semistructured interviews.


METHODS
Socio-economically disadvantaged areas, Belfast.


METHODS
Primigravidae, aged 16-30 years, without significant co-morbidity.


METHODS
Peer-mentoring by a lay-worker fortnightly during pregnancy and monthly for the following year, tailored to participants' wishes (home visits/telephone contacts), additional to usual care.


METHODS
Infant psychomotor and mental development (Bayley Scales of Infant Development (BSID-II)) at 1 year, assessed by an observer blinded to group allocation. Mothers' health at 1 year postnatal (SF-36).


RESULTS
Of 534 women invited, 343(64%) participated; 85%, with their children, completed outcome assessments (140 of 172 intervention; 152 of 171 controls). Intervention and control groups did not differ in BSID-II psychomotor (mean difference 1.64, 95% CI -0.94 to 4.21) or mental (-0.81, -2.78 to 1.16) scores, nor SF-36 physical functioning (-5.4, -11.6 to 0.7) or mental health (-1.8, -6.1 to 2.6). Women valued advice given in context of personal experience of child-rearing. Mentors gained health-related knowledge, personal skills and new employment opportunities.


CONCLUSIONS
Despite possible longer-term social advantage, this peer-mentoring programme showed no benefit for infant development or maternal health at 1 year. Further rigorous evaluation of important outcomes of complex interventions promoting health for children in socially disadvantaged communities is warranted.


BACKGROUND
ISRCTN 55055030.
Department of General Practice and Primary Care, Queen's University Belfast, Belfast, UK. m.cupples@qub.ac.uk
M E
ME
Cupples
M C
MC
Stewart
A
A
Percy
P
P
Hepper
C
C
Murphy
H L
HL
Halliday
D000293:Adolescent; D000328:Adult; D002657:Child Development; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008603:Mental Health; D008611:Mentors / Q000193:education; D009035:Mothers / Q000193:education* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D016487:Parenting; D010379:Peer Group; D011204:Poverty Areas; D011597:Psychomotor Performance; D012944:Social Support; D055815:Young Adult