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Article

The reflective component of the Mellow Bumps parenting intervention: Implementation, engagement and mechanisms of change

Details

Citation

Buston K, O’Brien R, Wight D & Henderson M (2019) The reflective component of the Mellow Bumps parenting intervention: Implementation, engagement and mechanisms of change. PLOS ONE, 14 (4), Art. No.: e0215461. https://doi.org/10.1371/journal.pone.0215461

Abstract
Understanding why parenting programmes work or do not work, and for whom, is crucial for development of more effective parenting interventions. In this paper we focus on a specific component of Mellow Bumps: reflection on one’s own childhood/past/life. We explore how this component was implemented, how participants engaged with it, the facilitating and constraining factors shaping this, whether and how it appeared to work, or not, and for whom. The paper analyses data from the Process Evaluation of the Trial of Healthy Relationships Initiatives for the Very Early years, which is evaluating two antenatal interventions delivered to vulnerable women, one of which is Mellow Bumps. Data were collected from January 2014 to June 2018 for 28 groups, 108 participants and 24 facilitators in a comprehensive and rigorous Process Evaluation designed to complement the Outcome Evaluation. Data were gathered at various time points using multiple methods, and were synthesised to triangulate findings. The reflective component was implemented with fidelity and participants engaged with it to varying degrees, dependent largely on the coherence of the group. Patchy attendance compromised the coherence of some groups, with the development of rapport, which is key to delivering reflective exercises, more difficult when group composition varied from week to week. Where there was a coherent group, powerful mechanisms of change, leading to stress reduction, included: relief through unburdening, empowerment through support given and received, reduced isolation through sharing anxieties, and control through self-care advice. A minority of highly vulnerable mothers seemed not to benefit from the reflective exercises and were marginalised within their groups. In order to minimise potential harmful effects of such exercises, allocation of participants to groups should strive to maximise group homogeneity. More research is needed to explore how very vulnerable parents can be supported in attending parenting interventions from start to finish.

Keywords
General Biochemistry, Genetics and Molecular Biology; General Agricultural and Biological Sciences; General Medicine

Journal
PLOS ONE: Volume 14, Issue 4

StatusPublished
FundersPublic Health Research Programme, Chief Scientist Office, Medical Research Council Canada, Medical Research Council Canada, Medical Research Council Canada and Medical Research Council Canada
Publication date16/04/2019
Publication date online16/04/2019
Date accepted by journal02/04/2019
URL
PublisherPublic Library of Science (PLoS)
eISSN1932-6203

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