Authors (including presenting author) :
Wong KWW(1), Yip SY(2), Cheng MYV(3), Wong YY(4), Chung PYJ(5)
Affiliation :
(1) Department of Paeditrics, (2) Department of Obstetrics (5) Department of Psychiatry, PYNEH (3)Community & Patient Resource Centre, PYNEH (4) Community Service, Hong Kong East Cluster
Introduction :
HKEC Comprehensive Child Development Service (CCDS) starting in 2012 provides early identification and management for children from at-risk families (maternal mental illness, perinatal mood disorders, substance abuse parents and teenage pregnancy) who are prone to be exposed to childhood adversities and chronic toxic stress that can alter the architecture of the developing brain. CCDS clinical teams under Department of Pediatrics, Department of Psychiatry and Department of Obstetrics and Gynecology organized a pilot program (CHAT WITH MOTHER & HUG PROJECTS) from April 2017- Mar 2019 in collaborations with Patient Resources Centre (PRC) and community partners to provide holistic psychosocial programs using multi-platforms and at different time points in a patient’s health journey.
Objectives :
(1) To enhance new mother’s knowledge on antenatal preparation, postnatal adjustment and mental well-being
(2) To improve parent-child attachment security through positive parenting interventions
(3) To promote reading aloud and improve child’s emergent literacy through book prescription
(4) To build up community support network to families with preschoolers
Methodology :
A referral system was developed by CCDS clinical team and PRC through OPAS. CCDS clinical team give advice on networking programs jointly designed by PRC and community partners. Regular meetings were conducted to monitor service progress and outcome.
The comprehensive program includes the followings:
(1) Health and community resources information in a designated webpage accessible with QR code under “healthyhkec” website set up by PRC
(2) Antenatal health talks on reading aloud and prevention of postnatal depression by community partners staff and CCDS psychiatric nurse
(3) Postnatal networking program/ workshops on mental wellbeing and parenting delivered by social workers at PRC and/or their centres at community
(4) Neonatal behavior observation with feedback to parents and book prescription by paediatrician at out-reach clinics
Data were collected to investigate the feasibility, receptivity and efficacy of these interventions.
Result & Outcome :
The program enlisted the help of Caritas Sau Kei Wan integrated family services centres (IFSC), Family Welfare Society North Point (IFSC), Baptist Oi Kwan integrated community centre for mental wellness (ICCMW), Bring Me a Book Foundation Hong Kong and TWGHs Ho Yuk Ching Educational Psychology Service Centre. It has successfully connected our patients to family & mental health resources at community. Our initial experience showed that scaled-up programs have high feasibility, receptivity and efficacy: From April 2017 to Mar 2019, hit rate of designated web page was 7832. The attendance to 27 antenatal health talks on perinatal mental health and reading aloud was 539 and 727 respectively. 24 sessions of postnatal network program/ postnatal workshop with 225 participants were rendered. Pre-post evaluation of the post-natal workshops in 2019 - The result demonstrated the programs could improve maternal mental wellbeing and improve parenting efficacy. In total 298 parents received “Neonatal Behavior Observation “guidance with positive verbal feedback. A pilot study on “Book prescription” by paediatrician at clinic in 2017 found significantly improved literacy orientation and home literacy environment for these high risk children. This scaled up medical social collaboration program successfully empowers and engages at-risk children and families at different time points of their patient-journey as shown by the improvement of maternal mental health and parent-child behavior. Through intersectoral partnerships coordinating clinical and community resources, the intervention becomes feasible, receptive and effective.
