Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial

Model effectiveness research report last updated: 2019

Model overview

Theoretical approach

In response to an increased number of children living in disadvantaged environments being referred for mental health care, the Parental Skills and Attachment in Early Childhood: Reduction of Risks Linked to Mental Health Problems and Promotion of Resilience Project (CAPEDP) was developed to promote infant mental health and reduce the incidence of infant mental health problems. CAPEDP drew on the framework from the Nurse-Family Partnership (NFP) model and Integrated Services for Perinatal Health and Early Childhood, a Canadian adaptation of the NFP. The model was based on Bandura’s self-efficacy theory, Bronfenbrenner’s ecological model of human development, and Bowlby’s attachment theory. CAPEDP was implemented within and designed to supplement the French system of free public mother-child support and prevention services.

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Model services

Psychologists provided home visits that focused on four themes: (1) the family and its social and cultural network, (2) the mother’s needs and health, (3) creating a safe and stimulating environment for the baby, and (4) the baby’s development. The specific content of the visits varied over the course of the intervention period (with different content offered in the prenatal, 0 to 6 months, 6 to 15 months, and 15 to 24 months periods). Home visitors tailored the visits to the varying needs of each family.

The home visitor recorded a video of the mother and child interacting during daily routines, such as bath and meal time. During the following visit, the home visitor and mother discussed the video together and the home visitor helped the mother reflect on her parenting practices.

To guide the visits, the home visitors used (1) a series of six DVDs on topics such as pregnancy, child care, and child development; and (2) a set of 39 brochures covering a variety of health and mental health topics related to promoting parent-child relationships.

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Intended population

The intended population included mothers who were younger than 26 years old, were less than 27 weeks pregnant, and spoke French fluently enough to actively participate in CAPEDP. Eligible participants also had to meet one or more of the following risk factors: had less than 12 years of education, qualified for free health care based on low-income status, or intended to raise the child in the absence of the father.

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Where to find out more

Antoine Guédeney
Department of Child & Adolescent Psychiatry
Hôpital Bichat Claude Bernard124 blv NEY
Paris, France 75018

Email: antoine.guedeney@bch.aphp.fr

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Effects shown in research

Maternal health

Findings rated moderate

Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Edinburgh Postnatal Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
3 months postpartum CAPEDP vs. usual care, Paris 367 mothers Unadjusted mean = 8.60 Unadjusted mean = 9.40 MD = -0.80 HomVEE calculated = -0.15 Not statistically significant, p = 0.33

Authors estimated the p-value using linear regression and adjusting for baseline Edinburgh Postnatal Depression Scale scores.

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In brief

Evidence of model effectiveness

Title General population Tribal population Domains with favorable effects
Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial Does not meet HHS criteria because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria. Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population.
  • No favorable effects found,

Model description

The Parental Skills and Attachment in Early Childhood: Reduction of Risks Linked to Mental Health Problems and Promotion of Resilience Project (CAPEDP) was a demonstration project in France, implemented from 2006 to 2011. CAPEDP enrolled pregnant women who were younger than 26 years old and had one or more of the following risk factors: had less than 12 years of education, qualified for free health care based on low-income status, or intended to raise the child in the absence of the father. The model was designed to promote infant mental health by addressing postnatal maternal depression, improving parenting skills, and promoting healthy mother-child attachment. Psychologists provided home visits that were guided by a series of six DVDs, brochures covering a variety of health and mental health topics, and video recordings of the mother-child interactions. CAPEDP offered families 44 home visits from the third trimester of the mother’s pregnancy to the child’s second birthday.

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Extent of evidence

Results of search and review
Number of manuscripts
At least one finding was eligible for review…
3
  …and at least one finding rated high
0
  …and at least one finding rated moderate (but none rated high)
1
  …and all findings that were eligible for review rated low or indeterminate2
2
  …but manuscript is additional source3
0

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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Summary of findings

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Criteria established by the U.S. Department of Health and Human Services

Information based on comprehensive review of all high- and moderate-rated manuscripts
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?No
3Favorable impacts on full sample?No
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
No
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
No
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