Filip Drozd

The transition to parenthood is associated with psychological, emotional, and social changes (Allan et al., 2013; Luciano et al., 2022). From a family-system perspective, individual experiences dur...

Guided digital interventions in maternity and child health care may improve mental health outcomes by increasing user engagement and adherence. However, implementing such complex interventions remains challenging due to factors related to intervention characteristics, organizational dynamics, professionals’ ompetencies, and user engagement. Understanding the experiences of those who deliver these interventions is essential to inform implementation efforts. This study explored midwives’ and public health nurses’ experiences of a guided digital intervention and the early implementation process three months post-training. Using a qualitative design, six focus groups were conducted with 32 professionals working in maternity and child health care services and participating in a multisite cluster-randomized trial of the universal digital intervention, Mamma Mia . Interviews were based on the Consolidated Framework for Implementation Research, and data were analyzed using reflexive thematic analysis. Three themes described how professionals made sense of implementing a guided digital intervention. “Broken Expectations – Navigating the Training-Practice Gap” reflected how abstract, decontextualized training left professionals’ feeling unprepared once faced with real-world implementation. “Balancing Belief and Doubt – Navigating digital care in relational professions” captured tensions between valuing innovation and safeguarding professional values, as participants negotiated whether digital tools could align with relational care practices. “Learning by Doing and Support – Future Optimism” illustrated a gradual shift toward acceptance, as hands-on experience and collegial support helped professionals view the intervention as complementary rather than disruptive. These findings underscore that implementing digital interventions in relational care settings is not solely a technical process but a relational and interpretive one. Effective implementation should therefore support contextual adaptation, provide practical and collaborative training, foster trust, and ensure organisational alignment.

BACKGROUND Infant and child sleep problems are common across cultures, affecting about 20% of children under 4 years old in Norway. Sleep problems can persist if left untreated and are associated with various negative outcomes for both children and parents. Despite the potential benefits of psychosocial and behavioral sleep interventions, access to and awareness of these interventions remain limited. The Internet represents a promising platform for disseminating evidence-based interventions. OBJECTIVE This study aimed to test and optimize core prototypes for an internet- and mobile-based intervention, Sleep Well, Little Sweetheart!, using the Youwell platform as a testbed. We examined the acceptability, appropriateness, feasibility, and usability of four prototypes: sleep assessment, parent emotion-regulation, behavioral sleep intervention, and altering nighttime feeding. METHODS We employed a triangulation design using the validating quantitative data model in a mixed methods approach for the prototype evaluation. A total of 104 participants signed up for prototype testing, of which 72 (69%) were parents and 32 (31%) were public health nurses or volunteers. Acceptability, appropriateness, and feasibility were assessed using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure, while usability was assessed using the System Usability Scale. Parents and public health nurses/volunteers were asked to assess the strengths, weaknesses, opportunities, and threats of each prototype using four qualitative, open-ended survey questions. RESULTS Testing of the prototypes highlighted their general acceptance, feasibility, appropriateness, and usability, as observed by both scores and participants’ qualitative feedback. Predominant themes that emerged from the qualitative data included Communication, Expansion, Relevance and Utility, and User-Friendliness. Although mean acceptance, feasibility, and usability scores were high across all prototypes, quantitative data revealed some differences among participants. Parents rated the feasibility of the sleep plan lower than public health nurses/volunteers, and the mindfulness prototype had the lowest usability score. CONCLUSIONS The evaluation indicates that the prototypes for addressing early childhood sleep problems were acceptable, feasible, and usable among parents and public health nurses/volunteers. These findings support the potential of digital platforms to improve access to evidence-based interventions and address a significant public health need. Future work will involve testing these prototypes as part of a comprehensive intervention package in real-world clinical settings and conducting clinical trials to evaluate the interventions’ effectiveness.

Background: Integrating evidence‐based interventions in services by midwives and public health nurses (PHNs) has the potential to improve public health. Attitudes and individual readiness to change can influence the implementation of evidence‐based interventions, but there is limited research in community nursing and maternity and child health care services (MCHCs). Aims: To examine attitudes toward evidence‐based practice and readiness to change in midwives and PHNs in MCHCs before implementing the “Mamma Mia” intervention (an evidence‐based intervention to improve maternal mental health). Methods: A survey‐based, multisite cross‐sectional study following the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guideline. Data were collected from 190 midwives and PHNs from 42 MCHCs across 33 municipalities in Norway (2021–2022). Six subscales of the Evidence‐Based Practice Attitude Scale (EBPAS) assessed attitudes toward evidence‐based practice, and the Brief Individual Readiness for Change Scale (BIRCS) measured individual readiness. Descriptive and inferential statistics using frequency tables, Pearson correlation coefficient, and linear regression were used for data analysis. Open‐ended responses were analyzed using content analysis. Results: Sixty‐five midwives and 125 PHNs completed the baseline survey (mean age 46.8, all female). Mean EBPAS subscales scores were 2.99 to 3.58 (SD = 0.46–0.77) mean BIRCS score was 3.16 (SD = 0.49) (possible range 0–4). Scores were slightly higher than typically reported in clinical settings, with no significant differences based on demographics (all p ‐values ≥ 0.166). EBPAS subscores and the BIRCS score showed a moderate positive association. The most frequently reported positive factors influencing readiness were “enhanced care and positive gain” (42.6%), “organizational support” (26.3%), and “receiving training and implementation support” (23.2%). Negative factors included “time constraints and workload” (58.4%), and “research participation and implementation demands” (27.9%). Linking Evidence to Action: Midwives and PHNs showed positive attitudes toward EBP and a high degree of individual readiness. Our findings align with previous research highlighting barriers such as time constraints and workload, offering insights to inform strategies for more effective EBP adoption and implementation. These results can guide nurse managers, administrators, policymakers, professional associations, implementers, and intervention developers in enhancing EBP integration into practice.

The Mamma Mia program is an internet-based intervention designed to prevent and/or intervene with perinatal mental health symptoms, such as depression symptoms. The purpose of this mixed-methods study, which occurred in a virtual setting, was to evaluate the perceived acceptability, obtrusiveness, and preliminary perceived usefulness of the Mamma Mia program by postpartum mothers who had access to the program through a larger parent study. Quantitative data on perceived obtrusiveness of the program (Unobtrusiveness Scale) were collected from 1772 pregnant women participating in a larger, three-arm randomized controlled parent study (clinicaltrials.gov: NCT04300894); qualitative data were obtained through semi-structured one-on-one interviews with a subset of these postpartum mothers (n = 55). Participants reported they found the program to be beneficial, emphasizing its guided content, focus on self-care, integration of mindfulness and educational components, and trustworthiness. Participants appreciated the structured nature of the program and expressed a high level of trust in the program, which was crucial for its perceived value and effectiveness. However, reported obtrusiveness of the intervention increased as participants progressed through the postpartum period, suggesting an evolving user experience with the program. Participants offered suggestions for improvement to the program, such as that the program should be app-based, the program should be available for partners to use, and that the program requires some updates to images and postpartum content. Overall, the study findings highlight the participants’ perceptions that the program is acceptable and useful. Future work is warranted to explore the enhancements proposed by participants to further optimize the program’s impact.

This study aimed to identify strategies for the implementation of a guided internet- and mobile-based intervention (IMI) for infant sleep problems (“Sleep Well, Little Sweetheart”) in well-baby and community mental health clinics. We used group concept mapping, a two-phased mixed methods approach, conducted as a two-day workshop in each clinic. We recruited 20 participants from four clinics and collected sorting and rating data for implementation strategies based on the Expert Recommendations for Implementing Change taxonomy and brainstorming sessions. Data were analyzed using descriptive statistics, multidimensional scaling, and hierarchical cluster analysis to create cluster maps, laddergrams, and Go-Zone graphs. Participants were presented with the results and discussed and interpreted the findings at each of the clinics in spring 2022. Participants identified 10 clusters of strategies, of which Training, Embedding and Coherence, User Involvement and Participation, and Clinician Support and Implementation Counseling were rated as most important and feasible. Economy and Funding and Interactive and Interdisciplinary Collaboration were rated significantly lower on importance and feasibility compared to many of the clusters (all ps < 0.05). There was a correlation between the importance and feasibility ratings (r =.62, p =.004). The use of group concept mapping made it possible to efficiently examine well-baby and community clinics’ perspectives on complex issues, and to acquire specific knowledge to allow for the planning and prioritization of strategies for implementation. These results suggest areas of priority for the implementation of IMIs related to infant sleep problems. The study was pre-registered at Open Science Framework (www.osf.io/emct8).

Aim and ObjectiveThe aim of this study was to explore mothers' and public health nurses' (PHN) experiences with sleep problems in children aged 6 months to 3 years in Norway. BackgroundSleep problems in children are common, affecting their health and development, and their mothers' well-being. It is also the primary reason parents seek help in well-child clinics (WCC). However, there is limited knowledge regarding the experiences of these mothers and the public health nurses who consult them. DesignQualitative design. MethodsFour semi-structured focus group interviews were conducted: two with mothers (n = 14) who had children with sleep problems and two with public health nurses (n = 14) from well-child clinics. The Framework Method was used for analysing the interviews of mothers. Data from public health nurses were charted onto the analytical framework of maternal data to understand how or whether public health nurses addressed the issues raised by mothers. The study is reported according to the COREQ checklist. ResultThe analysis resulted in two main themes: 'therapeutic alliance' (categories 'alliance ruptures' and 'demanding negotiation process') and 'reorganisation of identity' (categories 'unfulfilled expectations' and 'internal tension conflicts'). ConclusionYoung children's sleep problems present challenges to new mothers due to failed expectations, negatively affecting their feelings as mothers and towards their children, and consequently the reorganising of maternal identity. Most mothers experienced unsatisfactory therapeutic alliances while seeking help from public health nurses because advice was considered overly general, contradictory and unsafe for their children. Public health nurses were mostly aware of the parental consequences of children's sleep problems, but many appeared unable to help because of limited time and knowledge. Relevance to Clinical PracticePublic health nurses need to establish a therapeutic alliance and provide evidence-based knowledge and guidance on sleep problems while also considering women's reorganisation of identity when becoming mothers. Clinical Trial RegistrationOpen Science Framework: osf-registrations-6ag38-v1 ().

Aim: This study aims to review the existing literature on Internet‐based health interventions directed to support parents of children aged 0–5 years.Methods: We systematically searched electronic databases between January 2000 and 2018. The search consisted of terms describing eHealth, intervention and families and/or children.Results: Internet‐based parent support interventions were most often directed at rehabilitation and selective prevention, and we identified more studies on mental health (57%) than somatic health (41%). Developmental disorders were the most frequently studied mental health condition (n = 33), while interventions for obesity (15%) were the most studied somatic health condition. Forty‐four percent of mental health studies were RCTs and 65% of interventions were theory driven. Interventions most often used a behavioural approach, included guidance and delivered content via text‐based information.Conclusion: Several significant gaps were identified such as the need for more research outside of English‐speaking countries, more systematic reviews and effect studies. This review also elucidates the need for researchers to improve reporting on the theoretical approaches employed in interventions, and to focus on determining the importance of guidance. Finally, program developers should consider using more audio‐visual technology to avoid reinforcing social inequalities in access to healthcare.

There is a pressing need in the Nordic countries for evidence-based programmes for young children who have experienced early adversity. One such programme, Attachment and Biobehavioral Catch-up (ABC) was implemented in seven Norwegian child welfare services (CWS). The aim of this study was to interview families, CWS workers and their leaders to explore their experiences in implementing ABC and to make recommendations for future use. Semi-structured interviews were conducted with 10 parents, 11 parent coaches and eight CWS leaders. Data were analysed using the framework method. The findings showed that ABC’s core elements such as in-vivo commenting and video feedback, were considered important for bringing about change. The intervention’s strengths-based approach helped reduce parents’ resistance towards coaches and strengthen the therapeutic relationship. There were diverging perspectives regarding the duration of the intervention, though most agreed on the need to make adaptations to suit the needs of individual families. Coaches viewed ABC as a welcoming addition to their service, due to the lack of interventions for infants in the CWS, although an expanded age limit would enable the recruitment of more families. Recommendations for future implementation include addressing recruitment and how to address issues outside the scope of ABC sessions.