Evaluation of an intervention aimed at supporting new parents: the Baby Newsletter project.
BACKGROUND
Anticipatory guidance for parents is commonly used to improve parenting skills. The objective of this pre/post-intervention controlled study was to evaluate the effectiveness of a periodic newsletter with advice on childcare and development in improving parenting self-efficacy.


METHODS
This was a non-randomized pre/post-intervention controlled study. All the parents of children born between September 2014 and December 2015 resident in the S. Ilario d'Enza municipality (Italy) received eight Baby Newsletters. Parents resident in other municipalities of the same Health District were the control. Parents with linguistic barriers or with preterm or hospitalized children were excluded. Improvement in parenting self-efficacy was measured through the TOPSE (Tool to Measure Parenting Self-Efficacy) questionnaire during the first week (t0) after delivery and at 5 (t1) and 12 months (t2) of life at two vaccination appointments. A score ranging from 0 to 60 was computed for each of the eight domains investigated by the TOPSE. Variations of each TOPSE score between delivery and 12 months in the two groups were compared, adjusting for parity, education, age of parents, and child's sex, and stratifying by parity and education.


RESULTS /FINDINGS
One hundred thirty-six families accepted to participate in the study. Scores at 12 months were higher than 1 week after delivery in both groups for all TOPSE domains. The improvement was slightly stronger in the Newsletter group for almost all the skills except learning and knowledge [difference in the mean of variation: -0.48 (95% CI: - 3.17; 2.21)]; the difference was significant only for play and enjoyment [2.18 (95% CI: 0.12; 4.25)]. The increase in scores in almost all domains was more pronounced for parents with high education level at first child.


CONCLUSIONS
The intervention was effective in improving parents' ability to play. However, it risks worsening existing differences between parents with high and with low education levels.


TRIAL REGISTRATION
Clinical trial registration: NCT03268408 .
['Panza|Costantino|C|', 'Volta|Alessandro|A|', 'Broccoli|Serena|S|', 'Bonvicini|Laura|L|http://orcid.org/0000-0001-6773-5931', 'Kendall|Sally|S|', 'Marchesi|Maddalena|M|', 'Giorgi Rossi|Paolo|P|']
D000328:Adult D065187:Controlled Before-After Studies D004505:Education, Nonprofessional D005260:Female D006801:Humans D007558:Italy D008297:Male D009524:Newspapers as Topic D016487:Parenting D010290:Parents D010988:Play and Playthings D020377:Self Efficacy D011795:Surveys and Questionnaires
Parenting Anticipatory guidance Self-efficacy Infant Parent-child relationship Primary care