title: A randomized-controlled trial to examine the effectiveness of the 'Home-but not Alone' mobile-health application educational programme on parental outcomes.
abstract: OBJECTIVE
  To examine the effectiveness of Home-but not Alone, a postnatal psychoeducational programme delivered via a mobile-health application for parents during the early postpartum period to improve parenting outcomes.
  
  
  BACKGROUND
  The early postpartum period is often a challenging but crucial period for new parents. Supportive educational programmes delivered via mobile-health applications are needed to improve parenting outcomes.
  
  
  METHODS
  A randomized-controlled two-group pre-test and post-test design was adopted.
  
  
  METHODS
  Data were collected over 6 months (December 2015-May 2016) from 250 participants in a tertiary teaching hospital. They were randomly assigned to the intervention (n = 126) or control (n = 124) groups. Parental self-efficacy, social support, postnatal depression and parenting satisfaction were measured using reliable and valid instruments. A linear mixed method analysis was used to compare the percentage change of all outcome variables.
  
  
  RESULTS
  The intervention group had statistically significant improvements for parental self-efficacy, social support and parenting satisfaction at 4 weeks postpartum compared with the control group. Postnatal depression scores did not show any significant improvement compared with the control group.
  
  
  CONCLUSIONS
  The mobile-health application was effective in improving parental self-efficacy, social support and parenting satisfaction. Hence, it should be introduced and carried out in routine care by nurses. Further studies should focus on evaluating the effects of this programme in reducing postnatal depression amongst parents.
  
  
  BACKGROUND
  ISRCTN99092313.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: Shefaly
authors.identifier: http://orcid.org/0000-0001-5583-2814
authors.initials: S
authors.lastname: Shorey
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Ying/Y
authors.initials: Y
authors.lastname: Lau
authors.affiliation: Department of Psychiatry, University of Toronto, Canada.
authors.forename: Cindy-Lee
authors.initials: CL
authors.lastname: Dennis
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yah Shih
authors.initials: YS
authors.lastname: Chan
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Wilson W S
authors.initials: WWS
authors.lastname: Tam
authors.affiliation: Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009034:Mother-Child Relations / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000193:education*; D049590:Postpartum Period / Q000523:psychology*; D015397:Program Evaluation; D012846:Singapore; D017216:Telemedicine / Q000379:methods*
keywords: midwives; mobile-health application; nurses; parenting satisfaction; parenting self-efficacy; postnatal depression; postpartum period; psychoeducation; randomized-controlled trial; social support