Trial reportBMJ open2023
Non-specialist-delivered psychosocial intervention for prenatal anxiety in a tertiary care setting in Pakistan: a qualitative process evaluation.
Trial report in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03880032 (Happy Mother-Healthy Baby), which is not on this map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Happy Mother-Healthy Baby: An Anxiety-focused Early Prenatal Intervention for the Prevention of Common Mental Disorders in Pakistan
Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- An intervention to address prenatal anxiety improves maternal-infant bonding, with effects mediated by maternal-infant responsiveness, maternal self-efficacy, and postpartum depression.Infant mental health journal · 2025Trial
- A psychosocial intervention for prenatal anxiety decreases functional disability among pregnant Pakistani women: A moderated mediation approach using data from a randomized controlled trial.Journal of psychosomatic research · 2025Trial
- Multiple mediation analysis of a task-shared psychosocial intervention for perinatal anxiety: Exploratory findings from a randomized controlled trial in Pakistan.Journal of affective disorders · 2024Trial
- Impact of an intervention for perinatal anxiety on breastfeeding: findings from the Happy Mother-Healthy Baby randomized controlled trial in Pakistan.International breastfeeding journal · 2024Trial
- Results of a cognitive behavior therapy-based intervention for antenatal anxiety on birth outcomes in Pakistan: a randomized control trial.Scientific reports · 2024Trial
- Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial.Nature medicine · 2024Trial
- The Acceptability and Appropriateness of Delivering Postnatal Mental Health Support at Community Health Centers.Annals of the New York Academy of Sciences · 2026Article
- Strategies for spreading, scaling and sustaining perinatal mental health interventions in low- and middle-income countries (LMICs): A scoping review and thematic synthesis.Global mental health (Cambridge, England) · 2026Review
- The impact of Swanson's theory of caring on self-efficacy and pregnancy outcomes of primiparous women.Pakistan journal of medical sciences · 2025Article
- Unveiling barriers to maternal mental health in Pakistan: knowledge, attitudes and stigmas toward postpartum depression in social support systems.Frontiers in public health · 2025Article
- Peer counseling for perinatal depression in low- and middle-income countries: A scoping review.Global mental health (Cambridge, England) · 2024Article
- Exploring preference for delivery methods for a psychosocial intervention for prenatal anxiety: A qualitative study from a tertiary care hospital in Pakistan.Global mental health (Cambridge, England) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 5 countries.
Funding
Abstract
objectivesA manualised cognitive-behavioural therapy-based psychosocial intervention for prenatal anxiety called Happy Mother Healthy Baby is being tested for its effectiveness through a randomised control trial in Pakistan. The aim of this study was to evaluate the intervention delivery process and the research process.
designQualitative methods were used to explore in depth the intervention delivery and research process.
settingThis process evaluation was embedded within a randomised control trial conducted in a tertiary care facility in Rawalpindi, Pakistan.
participantsData were collected through in-depth interviews (n=35) with the trial participants and focus group discussions (n=3) with the research staff. Transcripts were analysed using a Framework Analysis.
resultsThe evaluation of the intervention delivery process indicated that it can be effectively delivered by non-specialist providers trained and supervised by a specialist. The intervention was perceived to be culturally acceptable and appropriately addressing problems related to prenatal anxiety. Lack of awareness of 'talking' therapies and poor family support were potential barriers to participant engagement. The evaluation of the research process highlighted that culturally appropriate consent procedures facilitated recruitment of participants, while incentivisation and family involvement facilitated sustained engagement and retention. Lack of women's empowerment and mental health stigma were potential barriers to implementation of the programme.
conclusionWe conclude that non-specialists can feasibly deliver an evidence-based intervention integrated into routine antenatal care in a tertiary hospital. Non-specialist providers are likely to be more cost effective and less stigmatising. Inclusion of family is key for participant recruitment, retention and engagement with the intervention. TRIAL REGISTRATION NUMBER: NCT03880032.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.