“Enjoy your baby” Internet-based CBT for mothers with babies: a feasibility randomised control trial

Background: Postnatal depression is a global health problem with lasting effects on the family. Government policy is focussed on early intervention and increasing access to psychological therapies. There is a growing evidence base for the use of computerised CBT packages and this study investigated the feasibility of a CBT-based self-help internet intervention for new mothers. Objective: To assess the ability to recruit mothers, deliver an internet course, obtain follow-up data and evaluate what mothers think of the course. Design: A feasibility randomised control design was used to compare a waiting list control group (delayed access= DA) to the Enjoy Your Baby course (immediate access= IA). Measures were administered at baseline and 8 week follow-up. Methods: Adverts were placed in the Metro freesheet, on charity web pages, on social media, posters were put up in the community, and leaflets were handed out at mother and baby groups. Participants had to be 18 years old or over with a child less than 18 months old. The IA arm was given access to the course straight away. After 8 weeks all participants were asked to recomplete the original measures and those in the IA arm also gave feedback on the course. Participants in the DA arm were given access after recompleting the questionnaires. Due to a lack of follow-up data a small discussion group was conducted. Intervention: The course contains 4 core modules including helping mothers understand why they feel the way they do and helping them build closeness to their babies. Additional modules, worksheets and homework tasks were available. The DA group were given a list of additional support resources and services, and encouraged to seek additional help if required. All participants received weekly automated emails for 12 weeks as they worked through the course. It was not possible to deliver individualised support. 34 Results: Despite using a number of recruitment strategies, recruitment was lower and slower than anticipated, and attrition was high. 41 women, primarily recruited via the internet, were randomised (IA n=21, DA n=20). No significant differences were observed between participants in either arm at baseline and no statistically significant differences were identified when the demographics and baseline measures of participants who logged-on to the course were compared to those who did not, or when participants who completed follow-up measures were compared to those who did not. Pre and post intervention scores on the EPDS approached statistical significance (P=.059, r=.444) favouring the intervention arm. The discussion group suggested strengths of the course and recommended areas for improvement, including making the course more mobile friendly. Conclusion: Internet interventions show promise; however it is difficult to recruit mothers, engagement is low and attrition high. A number of recommendations are made and a further pilot or an internal pilot of a larger substantive study should be conducted to confirm recruitment and retention. Trial ID: ISRCTN90927910.

Program Annotations: Feedback for Students Learning to Program

This paper presents a novel program annotation mechanism which enables students to obtain feedback from tutors on their programs in a far simpler and more efficient way than is possible with, for example, email. A common scenario with beginning students is to email tutors with copies of their malfunctioning programs. Unfortunately the emailed program often bears little resemblance to the program the student has been trying to make work; often it is incomplete, a different version and corrupted. We propose an annotation mechanism enabling students to simply and easily annotate their programs with comments asking for help. Similarly our mechanism enables tutors to view students’ programs and to reply to their comments in a simple and structured fashion. This means students can get frequent and timely feedback on their programs; tutors can provide such feedback efficiently, and hence students’ learning is greatly improved.

Teacher praise and feedback and students’ perceptions of the classroom environment

The relationships between teacher praise and feedback, and students’ perceptions of the classroom environment were investigated in six rural elementary schools (n 5 747). The Teacher Feedback Scale and My Classroom Scale were developed as part of this study and used to collect the data. Structural equation modelling was used to test a hypothesised model. The results indicated that negative teacher feedback and effort feedback were both related to students’ relationships with their teachers, while ability feedback was associated with perceptions of the classroom environment. Praise was not related to classroom environment or teacher–student relationships. Significant age and gender differences were found. Additionally, differences were found between students who were satisfied with their classroom and those who were dissatisfied. Satisfied students received more general praise, general ability feedback, effort feedback and less negative teacher feedback when compared to dissatisfied students. Research studies have emphasised the influence of signicicant adults (teachers and parents) on students’ personal development (Porlier et al., 1999) and the importance of significant others’ verbal statements when directed at children (Burnett, 1996a). The relationships between negative and positive statements made by teachers, parents, peers and siblings and children’s self-talk have been investigated (Burnett, 1996a) and positive statements (praise) have been found to be more beneficial than verbal criticism (Burnett, 1999). The quality of life in the classroom in recent times has been considered of great importance to students (Thorp et al., 1994) and this is recognised by Baker (1999) who reported a relationship between students’ satisfaction with the learning environment, and differential teacher feedback and praise. This study investigated the relationships between teacher praise and feedback, and how students perceived their classroom and their relationship with their teacher.