Clinical effectiveness, implementation effectiveness and cost-effectiveness of a community singing intervention for postnatal depressive symptoms, SHAPER-PND: randomised controlled trial
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background Postnatal depression (PND) affects up to one in four mothers. However, they may experience barriers to access to conventional treatments, indicating a need for alternatives such as arts-based interventions. A previous trial showed that a 10-week singing intervention could alleviate symptoms of PND. Aims To evaluate, in a larger sample and across a longer timeframe than previously, the clinical effectiveness, implementation effectiveness and cost-effectiveness of the Melodies for Mums (M4M) singing intervention for symptoms of PND. Method One-hundred and ninety-nine mothers experiencing symptoms of PND (Edinburgh Postnatal Depression Scale score ≥10) and their babies were randomised to 10 weeks of in-person singing sessions (M4M, n = 133) or an active control (existing community-based mother–baby activities, n = 66). Mothers were re-assessed at weeks 6, 10, 20 and 36 for depression, healthcare use for themselves and their babies, and health-related quality of life according to the EQ5D-3. The perceived acceptability (Acceptability of Intervention Measure), appropriateness (Intervention Appropriateness Measure) and feasibility (Feasibility of Intervention Measure) of the activity were also assessed at week 6. Trial registration number: NCT04834622. Results Mothers in both groups experienced attenuation of depressive symptoms by week 10; however, those in the singing group maintained lower EPDS scores than those in the control group at week 20 (10.7 v . 12.2 (mean difference 95% CI [−2.96, −0.22]), P = 0.023) and week 36 (9.85 v . 11.4 [−2.93, −0.19], P = 0.026). Mothers in the singing group were also more likely to remain in the study (77 v . 57%, χ 2 (1) = 12.92, P < 0.001) and found their programme more acceptable (4.75 v. 4.0 [0.25, 0.83], U = 2436.5, P < 0.001), appropriate (4.25 v . 3.88 [0.12, 0.62], U = 2241.5, P < 0.001) and feasible (4.75 v . 4.0 [0.41, 0.91], U = 2568.0, P < 0.001). Finally, M4M was associated with 15 extra days of health and was found to be cost-effective (£126–539 per dyad). Conclusion M4M had a long-lasting effect on symptoms of PND and was perceived to be more suitable than existing activities; thus, M4M represents a worthwhile investment for healthcare systems as an intervention for mothers experiencing symptoms of PND.
Authors: Rebecca H. Bind, Andrew J. Lawrence, Carolina Estevao, Katie Hazelgrove, Kristi Priestley, Lavinia Rebecchini, Riddhi Laijawala, Celeste Miller, Andy Healey, Joan Agwuna, Nick Sevdalis, Ioannis Bakolis, Rachel Davis, Maria Baldellou Lopez, Anthony J. Woods, Nikki Crane, Manonmani Manoharan, Alexandra Burton, Hannah Dye, Tim Osborn, Lorna Greenwood, Rosie Perkins, Paola Dazzan, Daisy Fancourt, Carmine M. Pariante
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,920
Funders: South London and Maudsley NHS Foundation Trust, Wellcome Trust, King's College Hospital NHS Foundation Trust, National Institute for Health and Care Research, Department of Health and Social Care, King's College London, University College London, King's Health Partners, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Arts and Humanities Research Council, National Institute for Health Research Applied Research Collaboration South London
OpenAlex ID: W4415174677