Intervention during the Perinatal Period: Synthesis of the Clinical Practice Guidelines from the French National College of Midwives.

These clinical practice guidelines from the French National College of Midwives (CNSF) are intended to define the messages and the preventive interventions to be provided to women and co-parents by the different professionals providing care to women or their children during the perinatal period. These guidelines are divided into 10 sections, corresponding to 4 themes: 1/ the adaptation of maternal behaviors (physical activity, psychoactive agents); 2/ dietary behaviors; 3/ household exposure to toxic substances (household uses, cosmetics); 4/ promotion of child health (breastfeeding, attachment and bonding, screen use, sudden unexplained infant death, and shaken baby syndrome). We suggest a ranking to prioritize the different preventive messages for each period, to take into account professionals' time constraints.

Newborns' Bonding and Attachment, Their Rhythms and Needs, Supporting Parents Appropriately: Guidelines for Interventions During the Perinatal Period from the French National College Of Midwives.

A newborn's sleep-wake rhythms are very specific, neurologically determined, and different from the pattern of adults; they require an adaptable and predictable response by parents, which will promotes bonding and attachments, constructed at the early stages of development. It also will influence the quality of subsequent emotional relationships and adaptation to life events. This parental adaptability should receive multiprofessional support starting in the perinatal period, focused on the screening and management of psychological vulnerability.

[Maternal and child protection services at home. Results from a national study.].

Maternal and child protection services ("PMI") are French universal services providing prevention and health promotion services to parents and their newborn children up to the age of 6. They specifically offer home visitation services in order to reach families that could not be seen otherwise. This paper presents the results of a national survey describing these home visitation services and their local implantation.

Assessing a change mechanism in a randomized home-visiting trial: Reducing disrupted maternal communication decreases infant disorganization.

Although randomized interventions trials have been shown to reduce the incidence of disorganized attachment, no studies to date have identified the mechanisms of change responsible for such reductions. Maternal sensitivity has been assessed in various studies and shown to change with intervention, but in the only study to formally assess mediation, changes in maternal sensitivity did not mediate changes in infant security of attachment (Cicchetti, Rogosch, & Toth, 2006). Primary aims of the current randomized controlled intervention trial in a high-risk population were to fill gaps in the literature by assessing whether the intervention (a) reduced disorganization, (b) reduced disrupted maternal communication, and (c) whether reductions in disrupted maternal communication mediated changes in infant disorganization.

BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs.

Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities.

Objective: Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France.

Materials And Methods: CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440).

Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

Context: Postnatal maternal depression (PND) is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed.

Objective: This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties.

Implementation and assessment of an early home-based intervention on infant attachment organisation: the CAPEDP attachment study in France.

Attachment is a long-term emotional link between infants and their mothers. Attachment quality influences subsequent psychosocial relationships, the ability to manage stress and, consequently, later mental health. Home intervention programmes targeting infant attachment have been implemented in several contexts with varying degrees of efficacy.

Supporting families in challenging contexts: the CAPEDP project.

Although France has one of the most generous health and social care systems for infant and maternal well-being in the Western world, professionals have been increasingly concerned by the rising number of children being referred for mental health problems. The present article describes the first home-visiting program in France to specifically target mental health questions in families living in vulnerable contexts. The CAPEDP project, involving 440 women and their families, took place in Paris and its inner suburbs from 2006 to 2011.

Is the secure base phenomenon evident here, there, and anywhere? A cross-cultural study of child behavior and experts' definitions.

The evolutionary rationale offered by Bowlby implies that secure base relationships are common in child-caregiver dyads and thus, child secure behavior observable across diverse social contexts and cultures. This study offers a test of the universality hypothesis. Trained observers in nine countries used the Attachment Q-set to describe the organization of children's behavior in naturalistic settings.

A home-visiting intervention targeting determinants of infant mental health: the study protocol for the CAPEDP randomized controlled trial in France.

Background: Several studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood.

Method And Design: The objective of this multicentre randomized controlled parallel trial (PROBE methodology) is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study.

Evaluating fidelity in home-visiting programs a qualitative analysis of 1058 home visit case notes from 105 families.

Objective: Implementation fidelity is a key issue in home-visiting programs as it determines a program's effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011.

Method: To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses.

Infant rhythms versus parental time: promoting parent-infant synchrony.

Traditional psychoanalytic theories of early development have been put into question by developmental psychology, and particularly by attachment theory. Psychopathology appears to be more linked to interpersonal relationship problems rather than to intra-psychic conflict, as hypothesized in Freudian drive theory. Establishing synchrony between parent and infant is probably one of the major tasks of the first year of life.