Objective Interventions to reduce health inequalities for young children and their mothers are important: involving peers is recommended, but evidence of value for this approach is limited. The authors aimed to examine the effect of an innovative tailored peer-mentoring programme, based on perceived needs, for first-time mothers in socio-economically deprived communities.
Design Randomised controlled trial; parallel qualitative study with purposive samples using semistructured interviews.
Setting Socio-economically disadvantaged areas, Belfast.
Participants Primigravidae, aged 16–30 years, without significant co-morbidity.
Intervention Peer-mentoring by a lay-worker fortnightly during pregnancy and monthly for the following year, tailored to participants' wishes (home visits/telephone contacts), additional to usual care.
Main outcome measures Infant psychomotor and mental development (Bayley Scales of Infant Development (BSID-II)) at 1 year, assessed by an observer blinded to group allocation. Mothers' health at 1 year postnatal (SF-36).
Results Of 534 women invited, 343(64%) participated; 85%, with their children, completed outcome assessments (140 of 172 intervention; 152 of 171 controls). Intervention and control groups did not differ in BSID-II psychomotor (mean difference 1.64, 95% CI −0.94 to 4.21) or mental (−0.81, −2.78 to 1.16) scores, nor SF-36 physical functioning (−5.4, −11.6 to 0.7) or mental health (−1.8, −6.1 to 2.6). Women valued advice given in context of personal experience of child-rearing. Mentors gained health-related knowledge, personal skills and new employment opportunities.
Conclusions Despite possible longer-term social advantage, this peer-mentoring programme showed no benefit for infant development or maternal health at 1 year. Further rigorous evaluation of important outcomes of complex interventions promoting health for children in socially disadvantaged communities is warranted.
Trial registration no ISRCTN 55055030
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Funding The study was funded by the Research and Development Office, Northern Ireland, under the “Targeting Social Need” initiative. MEC was co-funded by the Centre of Excellence for Public Health (Northern Ireland), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, Research and Development Office for the Northern Ireland Health and Social Services and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
Competing interests None.
Ethics approval This study was conducted with the approval of the Central Office for Research Ethics Committees (Ref 124/03), Northern Ireland, April 2003.
Provenance and peer review Not commissioned; externally peer reviewed.