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Background <p>Maternal mental health is a global concern including in China. However, evidence on early prevention of maternal mental health problems in low- and middle-income countries is scarcely reported. This study sought to assess the effectiveness of a community-based home-visiting program facilitated by local Community Health Workers (CHWs) in rural areas of western China.</p> Methods <p>This study used randomized controlled trial, 592 pregnant women in the sample were randomly divided into treatment group and control group, and pregnant women in the treatment group received home visits from community health workers(CHWs).The main outcome was the mental health of pregnant women, which was measured using the Depression Anxiety and Stress Scale-21 (DASS-21). Average treatment effect analysis and local treatment effect analysis were used to analyze the effects of the CHWs’ home-visiting intervention on maternal mental health.</p> Results <p>The regression analysis showed that the home-visiting intervention did not have a positive impact on maternal mental health in rural areas. However, the effects of the intervention varied depending on family support. Specifically, when the husband accompanies antenatal care, the home-visiting intervention had a significant positive effect, reducing maternal depression and stress tendency scores by 0.1 and 2.14 points respectively (10% significance level). Additionally, for pregnant women with a satisfactory relationship with their husbands, the intervention reduced their depression scores by 0.61 and anxiety scores by 0.52 (10% significance level).</p> Conclusions <p>The interventions were not effective in improving the mental health of pregnant women on average. However, when pregnant women received greater family support and had a satisfying marital relationship, the interventions had a significant positive impact. Therefore, optimizing the design of the Community Health Worker (CHW) home-visiting intervention is essential to enhance its effectiveness.</p> Trial registration <p>Registration number ISRCTN98898991.Registered 26/03/2019.</p>

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The mental health benefit of a community-based home-visiting program for prenatal women: evidence from a randomized controlled trial in China

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  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Nan Wang,
  • Baowei Li,
  • Jie Yang,
  • Zhuo Liu,
  • Yaojiang Shi,
  • Jingchun Nie

摘要

Background

Maternal mental health is a global concern including in China. However, evidence on early prevention of maternal mental health problems in low- and middle-income countries is scarcely reported. This study sought to assess the effectiveness of a community-based home-visiting program facilitated by local Community Health Workers (CHWs) in rural areas of western China.

Methods

This study used randomized controlled trial, 592 pregnant women in the sample were randomly divided into treatment group and control group, and pregnant women in the treatment group received home visits from community health workers(CHWs).The main outcome was the mental health of pregnant women, which was measured using the Depression Anxiety and Stress Scale-21 (DASS-21). Average treatment effect analysis and local treatment effect analysis were used to analyze the effects of the CHWs’ home-visiting intervention on maternal mental health.

Results

The regression analysis showed that the home-visiting intervention did not have a positive impact on maternal mental health in rural areas. However, the effects of the intervention varied depending on family support. Specifically, when the husband accompanies antenatal care, the home-visiting intervention had a significant positive effect, reducing maternal depression and stress tendency scores by 0.1 and 2.14 points respectively (10% significance level). Additionally, for pregnant women with a satisfactory relationship with their husbands, the intervention reduced their depression scores by 0.61 and anxiety scores by 0.52 (10% significance level).

Conclusions

The interventions were not effective in improving the mental health of pregnant women on average. However, when pregnant women received greater family support and had a satisfying marital relationship, the interventions had a significant positive impact. Therefore, optimizing the design of the Community Health Worker (CHW) home-visiting intervention is essential to enhance its effectiveness.

Trial registration

Registration number ISRCTN98898991.Registered 26/03/2019.