Feasibility, acceptability and preliminary outcomes of the Parents Under Pressure program: a Canadian pilot study

Introduction The perinatal period is crucial for mothers and their offspring with various determinants of health that may influence experiences and susceptibility to negative outcomes. Programs, like Parents under Pressure (PuP), have been designed to reach at-risk mothers and improve well-being among mothers and their children, specifically during the first two years of life. Objectives This study primarily examined the feasibility and acceptability of the PuP program among at-risk women in Canada during their perinatal period. Secondary objectives included assessing changes in key functioning domains over time. Methods A mixed methods study was conducted in Ontario and Quebec, Canada from January 2021-March 2023. Mothers were recruited from five community agencies. Quantitative data were collected from mothers over four study visits. Qualitative interviews were conducted with a subset of mothers and PuP service providers. Data on the program’s feasibility and acceptability, domains of functioning including mental health, substance use, and parenting were analyzed. Results Fifty-five mothers consented to participating in the PuP program, with 51 completing the baseline assessment. The study met the research retention threshold, with 83 % of mothers completing the final research study (post-5 month) visit. However, only 64 % (n = 34) met the clinical retention threshold for the PuP program (6 + modules or provider completed the closure module). Reasons for incompletion included life changes and loss of interest in the program. Qualitative interviews indicated the program was acceptable to both mothers and providers and identified barriers to implementation. Discussion While the PuP program was well-received by both mothers and providers, its feasibility in this context was limited, potentially due to the high-risk sociodemographic characteristics of the sample or external factors such as staff turnover. Future studies may consider adapting the program to include group-based or online components to better meet mothers’ needs.