RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth

Abstract Background Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive nega...

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Main Authors: Brittannia Volkmer, Yogini Sawjani, Mary Newburn, Jo Bennett, Megan McGovern, Laura Bridle, Nathalie Towner, Laura McCabe, Katherine Clark, Sophie Webster, Alison Hylton-Potts, Lucy Mayer, Gertrude Senevirante, Debra Bick, Jill Newby, Kimberley Goldsmith, Michelle L. Moulds, Colette Hirsch
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Trials
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Online Access:https://doi.org/10.1186/s13063-024-08516-9
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author Brittannia Volkmer
Yogini Sawjani
Mary Newburn
Jo Bennett
Megan McGovern
Laura Bridle
Nathalie Towner
Laura McCabe
Katherine Clark
Sophie Webster
Alison Hylton-Potts
Lucy Mayer
Gertrude Senevirante
Debra Bick
Jill Newby
Kimberley Goldsmith
Michelle L. Moulds
Colette Hirsch
author_facet Brittannia Volkmer
Yogini Sawjani
Mary Newburn
Jo Bennett
Megan McGovern
Laura Bridle
Nathalie Towner
Laura McCabe
Katherine Clark
Sophie Webster
Alison Hylton-Potts
Lucy Mayer
Gertrude Senevirante
Debra Bick
Jill Newby
Kimberley Goldsmith
Michelle L. Moulds
Colette Hirsch
author_sort Brittannia Volkmer
collection DOAJ
description Abstract Background Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)—such as worrying about ways things will go wrong in the future or ruminating about past negative events—is a risk factor for the development of anxiety. RNT is maintained by the tendency to generate negative interpretations of ambiguous situations. Methods A parallel two-arm randomised controlled trial will assess the efficacy of adding interpretation training (RELAX) to usual maternity care. Participants (N = 268) will be randomised to (i) 12 sessions of online interpretation training (RELAX) plus usual care, or (ii) usual care alone. We will assess anxiety, depression, RNT, and work and social adjustment at baseline, plus 4, 8 and 36 weeks later. Discussion Should the intervention result in lower levels of anxiety than usual care, it could be an accessible, cost-effective way to help women who are vulnerable to experiencing anxiety in the perinatal period. Trial registration ISRCTN 12754931. Registered 25th May 2023, prior to recruitment.
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spelling doaj-art-185c9d4e0f504c3199b64fe883dcc51e2025-08-20T02:11:49ZengBMCTrials1745-62152024-10-0125111910.1186/s13063-024-08516-9RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birthBrittannia Volkmer0Yogini Sawjani1Mary Newburn2Jo Bennett3Megan McGovern4Laura Bridle5Nathalie Towner6Laura McCabe7Katherine Clark8Sophie Webster9Alison Hylton-Potts10Lucy Mayer11Gertrude Senevirante12Debra Bick13Jill Newby14Kimberley Goldsmith15Michelle L. Moulds16Colette Hirsch17Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonKing’s College Hospital NHS Foundation TrustInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Women’s and Children’s Health, Guy’s and St Thomas’ NHS Foundation Trust, c/o, North Wing, St Thomas’ HospitalKing’s College Hospital NHS Foundation TrustKing’s College Hospital NHS Foundation TrustEpsom and St Helier University Hospitals NHS TrustMid Cheshire Hospitals NHS Foundation Trust, C/O Leighton HospitalSouth London and Maudsley NHS Foundation Trust, Maudsley HospitalWarwick Clinical Trials Unit, Warwick Medical SchoolBlack Dog InstituteDepartment of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonSchool of Psychology, Faculty of Science, UNSW SydneyInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract Background Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)—such as worrying about ways things will go wrong in the future or ruminating about past negative events—is a risk factor for the development of anxiety. RNT is maintained by the tendency to generate negative interpretations of ambiguous situations. Methods A parallel two-arm randomised controlled trial will assess the efficacy of adding interpretation training (RELAX) to usual maternity care. Participants (N = 268) will be randomised to (i) 12 sessions of online interpretation training (RELAX) plus usual care, or (ii) usual care alone. We will assess anxiety, depression, RNT, and work and social adjustment at baseline, plus 4, 8 and 36 weeks later. Discussion Should the intervention result in lower levels of anxiety than usual care, it could be an accessible, cost-effective way to help women who are vulnerable to experiencing anxiety in the perinatal period. Trial registration ISRCTN 12754931. Registered 25th May 2023, prior to recruitment.https://doi.org/10.1186/s13063-024-08516-9AnxietyRepetitive negative thinking (RNT)Perinatal mental healthDigital therapyCognitive bias modification (CBM)Prevention
spellingShingle Brittannia Volkmer
Yogini Sawjani
Mary Newburn
Jo Bennett
Megan McGovern
Laura Bridle
Nathalie Towner
Laura McCabe
Katherine Clark
Sophie Webster
Alison Hylton-Potts
Lucy Mayer
Gertrude Senevirante
Debra Bick
Jill Newby
Kimberley Goldsmith
Michelle L. Moulds
Colette Hirsch
RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
Trials
Anxiety
Repetitive negative thinking (RNT)
Perinatal mental health
Digital therapy
Cognitive bias modification (CBM)
Prevention
title RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
title_full RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
title_fullStr RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
title_full_unstemmed RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
title_short RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
title_sort relax reducing levels of anxiety a study protocol for a parallel two arm randomised controlled trial evaluating a web based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth
topic Anxiety
Repetitive negative thinking (RNT)
Perinatal mental health
Digital therapy
Cognitive bias modification (CBM)
Prevention
url https://doi.org/10.1186/s13063-024-08516-9
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