The COSI trial: a study protocol for a multi-centre, randomised controlled trial to explore the clinical and cost-effectiveness of the Circle of Security-Parenting Intervention in community perinatal mental health services in England

Bibliographic Details
Title: The COSI trial: a study protocol for a multi-centre, randomised controlled trial to explore the clinical and cost-effectiveness of the Circle of Security-Parenting Intervention in community perinatal mental health services in England
Authors: Camilla Rosan, Kim Alyousefi-van Dijk, Zoe Darwin, Daphne Babalis, Victoria Cornelius, Rachel Phillips, Lani Richards, Hannah Wright, Steve Pilling, Pasco Fearon, Elena Pizzo, Peter Fonagy
Source: Trials, Vol 24, Iss 1, Pp 1-17 (2023)
Publisher Information: BMC, 2023.
Publication Year: 2023
Collection: LCC:Medicine (General)
Subject Terms: Perinatal mental health, Circle of Security-Parenting, Parent-infant bonding, Child development, Child attachment, Randomised controlled trial, Medicine (General), R5-920
More Details: Abstract Background Perinatal mental health difficulties affect up to 27% of birthing parents during pregnancy and the first postnatal year, and if untreated are associated with difficulties in bonding and long-term adverse outcomes to children. There are large evidence gaps related to psychological treatment, particularly in group therapy approaches and parent-infant interventions. One intervention showing preliminary efficacious findings and user acceptability is Circle of Security-Parenting (COS-P), which is a brief, weekly, group programme. However, these studies were underpowered and predominantly non-randomised, and there has never been a research trial in England or with birthing parents experiencing severe and complex perinatal mental health difficulties. The aim of the research is to conduct a randomised control trial to test whether COS-P will reduce perinatal mental health symptoms in birthing parents accessing NHS perinatal mental health services, compared to treatment as usual (TAU). Secondary objectives include exploring whether the intervention improves parenting sensitivity, emotion regulation skills, attachment security and infant development. Additionally, the project aims to examine whether the intervention is acceptable to parents and NHS staff, and whether it is cost-effective. Methods COSI is an individually randomised, single-blind parallel arm controlled trial with an embedded internal pilot aiming to recruit 369 participants in a 2:1 ratio (intervention: TAU). Participants will be recruited from ten NHS community perinatal mental health services in England and screened based on clinical levels of both mental health symptoms (average CORE-OM score ≥ 1.1) and postnatal bonding difficulties (total PBQ score ≥ 12). This trial has 90% power to detect a MCID of 5 points on the CORE-OM. Primary and secondary outcomes will be measured at baseline, 3, 7 and 12 months after baseline. Service use and quality of life measures will also be collected alongside a process evaluation of parents’ and interveners’ views and experiences. Discussion This will be the first large pragmatic trial to test whether COS-P is effective for birthing parents with severe and complex perinatal mental health difficulties in improving their mental health symptoms. If shown to be effective, the intervention could be delivered widely across the NHS and other similar services globally. Trial registration ISRCTN, ISRCTN18308962. Registered 18 February 2022.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1745-6215
Relation: https://doaj.org/toc/1745-6215
DOI: 10.1186/s13063-023-07194-3
Access URL: https://doaj.org/article/a0d05f650b614daaa2521a49173e000c
Accession Number: edsdoj.0d05f650b614daaa2521a49173e000c
Database: Directory of Open Access Journals
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More Details
ISSN:17456215
DOI:10.1186/s13063-023-07194-3
Published in:Trials
Language:English