WEBVTT

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In this video, we examine
some of the key methods

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of working at each of the
different levels described

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in the earlier part of
the course-- universal,

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targeted, and indicated.

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So let's start at
the universal level.

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One of the most common
universal methods of working

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involves media-based strategies.

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And we will see in
the later section

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that some of the media-based
methods of working

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that have been developed
for the postnatal period

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include newsletters
and websites.

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However, there's
currently no evidence

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about the effective
media-based methods

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of working explicitly
in the prenatal period.

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In the UK, another universal
level intervention that we use

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are antenatal
promotional interviews.

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These are provided
by health visitors

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to all pregnant
women with the aim

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of supporting a
healthy pregnancy

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and promoting the
developing relationship

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with the unborn baby.

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But they're also used
to screen for women

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who may need additional
support, such as women

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who are experiencing
anxiety or depression.

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The promotional
interview consists

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of an hour-long
semi-structured interview

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which is conducted at
around 28 weeks of pregnancy

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and then again at
around 6 to 8 weeks

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postnatal, both interviews being
conducted by the same health

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visitor.

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Another method of working that's
been developed over the past 10

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years in response to some of
the evidence that we examined

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earlier in this course are
preparation for parenthood

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programmes, which can be
delivered either as part

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of universal or
targeted approach.

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These programmes are provided
to groups of parents.

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And they typically
begin in pregnancy,

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and continue into the
immediate postnatal period,

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and consist of a weekly
two-hour session over the course

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of around 8 to 9 weeks.

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Examples of universal
preparation for parenthood

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programmes include Triple P for
Babies and programmes that have

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been developed by a range
of voluntary organisations,

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including the National
Childbirth Trust,

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Bumps&Babies Programme, the
Solihull Approach Antenatal

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Parenting course.

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A small number of group-based
preparation for parenthood

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programmes have been designed
for use as part of a targeted

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approach.

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For example, Mellow Bumps is
a 6-week group-based antenatal

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programme, delivered between
20 to 30 weeks gestation

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and designed to support
families with additional health

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and social care needs.

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The programme is aimed at
decreasing maternal antenatal

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stress levels,
increasing the expectant

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mothers' understanding of
the newborn baby's capacity

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for social interaction, and
emphasises the importance

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of early interaction in
enhancing brain development

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and attachment.

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Similarly, Baby Steps
has been designed for use

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with vulnerable
parents and consists

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of six group-based
sessions spanning

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the perinatal period,
complemented by two home

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visits.

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Baby Steps is provided
by two specially trained

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practitioners.

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However, possibly one of
the most popular methods

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of supporting women with
additional needs are home

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visiting programmes.

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Many home visiting
programmes are underpinned

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by Bronfenbrenner's
ecological theory,

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which emphasises the importance
of the interrelationship

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between the individual and the
wider systems within which they

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are located, such as, for
example, the family, school,

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neighbourhood, society,
and wider culture.

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The focus of such
programmes is, therefore,

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on helping parents to
develop strategies to prevent

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or address problems that can
occur within each of these

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systems and includes, for
example promoting healthy

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behaviours in
pregnancy, supporting

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the mother's relationship
with the baby,

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and encouraging her to develop
her education and delay

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subsequent pregnancies.

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Possibly one of the best
examples of such a programme is

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the Nurse Family Partnership,
which is provided by specially

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trained nurses to single teenage
mothers beginning in pregnancy

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and continuing until the
baby is 24 months of age.

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In terms of women who are
experiencing problems such

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as domestic violence,
substance dependency,

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or severe mental
health problems,

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although there is limited
evidence of effective methods

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of working in pregnancy
with these groups of women,

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good practise should, of course,
involves the midwife or another

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primary care practitioner,
ensuring that this high-risk

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group of women have access
to specialist practitioners,

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such as domestic
abuse, substance use,

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or mental health workers.

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These practitioners
will provide them

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with the necessary
specialist support

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and ensure that,
where appropriate,

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referrals are made to the
relevant Child Protection

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Agencies, particularly
where there's domestic abuse

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or substance dependency.

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Watch the next video,
which shows a Nurse Family

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Partnership home visitor and
the mother who she visited.

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And then read the
related article,

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which describes research
that has followed up

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families who received this
intervention until the children

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were 15 years of age.

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If you would like to know more
about other methods of working

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in pregnancy that are
supported by the evidence,

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you might like to read
the additional article

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that we have provided.

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Also, please share with us your
thoughts about these methods

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of working in the discussions.

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