Caring for Caregivers: A Postnatal Wellbeing Program

The Caring for Caregivers Trial is a feasibility proof-of-concept pre- and post-trial evaluating the feasibility, acceptability, and effectiveness of a caregiver wellbeing program delivered by Child and Family Health Services (CaFHS) in South Australia. The caregiver wellbeing program was codesigned and developed in 2023. This was achieved through undertaking three activities: 1) a service review where we mapped existing services available within CaFHS, 2) focus groups with 25 caregivers who have access CaFHS services and 9 CaFHS service providers, and 3) a scoping review examining 70 evidence-informed programs and interventions that support caregiver wellbeing and self-care. Through triangulating the results of these three activities and working closely with CaFHS leadership, consumer researchers, and the CaFHS consumer advisory committee, we used the Intervention Mapping Methodology to develop a caregiver wellbeing program that is relevant, feasible and evidence-informed that could be implemented by CaFHS. A maximum of four South Australian CaFHS sites will be selected and randomly allocated to be either a control site, or an intervention site. The caregiver wellbeing program will be implemented into routine Early Parenting Groups delivered at the intervention sites over a 2-month period. CaFHS Early Parenting Groups comprise of 2-hour weekly sessions for 4 weeks. The caregiver wellbeing program will be implemented in week 3 and will replace the usual week 3 content. Weeks 1, 2, and 4 will be delivered by the usual CaFHS facilitator, however, week 3 will be delivered by the CaFHS project manager (a registered nurse and midwife) and all caregivers enrolled into an Early Parenting Group at an intervention site during the study period will receive the evidence-informed caregiver wellbeing program. Early Parenting Groups on average have approximately 10 caregivers. The caregiver wellbeing program comprises of approximately 2 hours of content that is structured with a powerpoint presentation and focuses primarily on delivering evidence-informed psychoeducation and facilitation group discussions. Overall the program covers 5 objectives. The objectives are: 1. Understanding Mental Health, Parenting and Seeking Support 2. Discussing Norms, Expectations, and Individualised Experience 3. Navigating Relationships and Social Connections 4. Empowering Self-Worth and Self-Care Strategies 5. Providing Support for Accessing Services and Seeking Help The project manager will monitor fidelity through a project specific fidelity checklist to track if all 5 objectives are achieved in the class. The project manager will also write reflections in a research journal after each class to keep qualitative notes relating to time spent on each objective, observations regarding participant responses to the content, any ad hoc adaptations to content due to participant engagement, etc. To further understand the feasibility and fidelity of implementation and acceptability of the caregiver wellbeing program, focus groups will be conducted with approximately 10-15 caregivers who received the intervention and 10-15 CaFHS staff involved in implementation. Participants will be selected as the first 15 to opt-in. Focus groups will be with approximately 5-10 participants and will be conducted by the Flinders University research team (lead researcher and research assistants) and the discussion will focus on 1) the impact of the program on mental health and wellbeing, 2) what was liked or disliked about the content, 3) if there are any concerns regarding the content or how it was delivered, 4) if they would like any modifications to the content or how it was delivered. Specifically, staff will additionally be asked 1) how well the content and the delivery integrates into routine services, 2) if there were any challenges to delivery or implementation, and 3) perspectives on whether the program would work in other CaFHS sites.