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CompletedNCT02047357ROSHNIUpdated Oct 30, 2017

Participatory Intervention to Reduce Maternal Depression and Under Five Child Morbidity

An interventional study of Learning Through Play Plus in Maternal Depression, sponsored by Pakistan Institute of Living and Learning. Completed at 1 site in Pakistan. Open to female participants aged 18 Years to 44 Years. Per ClinicalTrials.gov, last updated 2017-10-30.

Sponsored by Pakistan Institute of Living and Learning · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
774
Allocation
Randomized
Ages
18 Years to 44 Years
Sex
Female
01

Study summary

To test the efficacy of an innovative affordable intervention program that can be used by non-specialists, including mothers and lady health workers with minimal training in low resource countries such as Pakistan

Read the detailed description

Specific challenges: In Pakistan rates of depression particularly in women are high, as well as other risks to the growth and development of young children and child mortality. Numerous studies provide compelling evidence that maternal depression not only affects mothers but is also associated with long term emotional, cognitive and behavioural problems in children. Depressed mothers are unable to provide primary care necessary for growth of their children during the first 3-years of life, a critical period for child development. Disability due to depressive symptoms (such as fatigue, poor concentration, loss of interest) is likely to affect child-care abilities directly, while impaired social functioning is likely to have indirect consequences through lack of support in childcare. Disturbances in mother-infant relationship in depressed mothers negatively influence the child's development. There is now evidence from some low income countries that effectively delivered participatory group interventions are cost effective intervention for improving maternal and child health. The Community-Based participatory Intervention LTP Plus has been designed to address maternal depression and a parenting program of child psychosocial development through mother-infant play providing stimulation, and support for exploration and autonomy for the infant.The proposed study will test the efficacy of an innovative affordable intervention program that can be used by non-specialists, including mothers and lay health workers with minimal training in low resource countries such as Pakistan.

Project Impact: LTP Plus is proposed as a low cost intervention to improve maternal mental and physical health, reduce infant and children under five years' morbidity and mortality, and promote healthy child development. Learning Through Play (LTP) Plus is a low-literacy, sustainable program intended to provide parents with information on the healthy growth and development of their young children. The LTP research-based activities enhance children's development while simultaneously promoting attachment security through building parents' ability to read and be sensitive to their children's cues and through active involvement in their children's development. Plus the Thinking Healthy Program (THP) which adopts 'here and now' problem-solving approach, THP uses cognitive behavior therapy (CBT) techniques of active listening, changing negative thinking, and collaboration with the family.

02

Conditions studied

  • Maternal Depression

Keywords

  • Maternal depression
  • Mother
  • Child
  • LTP
  • Learning Through Play
  • Healthy thinking
03

In context

Depression

8,057 studies on the registry are indexed under Depression; 1,643 are open to participants now.

This study's enrollment of 774 is above the median of 84 across 6,718 interventional studies indexed under Depression.

Browse Depression studies →

Lead sponsor

Pakistan Institute of Living and Learning is the lead sponsor of 59 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 44 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Participants will be included in the study if they are:

    • 18 to 44 years old Mothers with children aged between 0-30 months
    • Resident in the trial site catchments area
    • Ability to complete a baseline assessment

Exclusion criteria

Exclusion Criteria:

  • Participants will be excluded from the study if they have:

    • A medical disorder that would prevent participation in clinical trial.
    • Temporary resident unlikely to be available for follow up.
    • Active suicidal ideation or any other severe or physical mental disorder
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
774 participants (actual)

Study arms

  • Experimental
    Intervention Arm

    Learning Through Play Plus

    Other: Learning Through Play Plus

  • No intervention
    Control

    This arm will receive no intervention

Interventions

  • OtherLearning Through Play Plus

    Learning Through Play (LTP) Plus is a low-literacy, sustainable program intended to provide parents with information on the healthy growth and development of their young children. The LTP research-based activities enhance children's development while simultaneously promoting attachment security through building parents' ability to read and be sensitive to their children's cues and through active involvement in their children's development. Plus the Thinking Healthy Program (THP) which adopts 'here and now' problem-solving approach. THP uses cognitive behavior therapy (CBT) techniques of active listening, changing negative thinking, and collaboration with the family.

    Also known as: Psycho social intervention

06

What researchers measure

Primary outcomes

  1. EPDS

    The EPDS is a self-report questionnaire composed of ten items scored on a four-point scale (0-3) designed to assess pregnancy and postpartum depression Cox et al. (1987).

    Time frame: Change from Baseline to 3 month

Secondary outcomes

  1. Knowledge of Expectation and Child Development

    A 20-item questionnaire will be used to assess maternal knowledge and expectations for child development in the first three years. A change in mothers' knowledge was reported for Pakistani mothers who participated in LTP (Rahman et al, 2009).

    Time frame: Baseline, 3 months and 6 months

  2. Patient Health Questionnaire (PHQ) (Kroenke, Spitzer, Williams et al, 2001)

    The Patient health Questionnaire (PHQ) is a simple 10 item self-report questionnaire can also be administered by a trained research worker. A score of 10 or more is taken as cut -off for depressive disorder

    Time frame: Baseline, 3 month and 6 month

  3. Generalized Anxiety Disorder (GAD) 7 (Spitzer, R. L., Kroenke, K., Williams, J. B., & Lowe, B. 2006)

    The GAD-7 is a 7 item scale used to screen for and measure severity of Genralised Anxiety Disorder. Scores of 5, 10 \& 15 are taken as cut-off points for mild, moderate and high

    Time frame: Baseline, 3 month and 6 month

  4. Clinical Interview Schedule Revised (CISR)

    The clinical Interview Schedule-Revised is a fully structured diagnostic instrument that was developed from an existing instrument, the Clinical Interview Schedule (CIS), assessing minor psychiatric morbidity in the community, general hospital, occupational and primary care research

    Time frame: Baseline, 3 month and 6 month

  5. Quality of life (EQ 5 D)

    It is a measure of health and quality of life. This is a standardised instrument for use as a measure of health outcome; it provides a simple descriptive profile and a single index value for health status.

    Time frame: Baseline, 3 month and 6 month

Other outcomes

  1. Cost effectiveness analysis

    It is used for evaluating cost effectiveness analysis

    Time frame: Baseline, 3 month and 6 month

07

Study locations

1 site
  • Community, Gadap
    Karachi, Sindh 75780, Pakistan
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 30, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT02047357
Lead sponsor
Pakistan Institute of Living and Learning
Collaborators
Grand Challenges Canada, The Hincks-Dellcrest Centre
Responsible party
Sponsor
First posted
Jan 28, 2014
Start date
Dec 2013
Primary completion
Nov 2015
Completion
Dec 2015
Last update
Oct 30, 2017

Study contacts

Batool Fatima
principal investigator · Pakistan Institute of Living and Learning
Nancy Cohen, Ph.D
principal investigator · The Hincks-Dellcrest Centre

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2017. You cannot join it, but the record below documents what was studied.

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