The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial registered on ANZCTR


Registration number
ACTRN12625000903482
Ethics application status
Approved
Date submitted
1/08/2025
Date registered
20/08/2025
Date last updated
20/08/2025
Date data sharing statement initially provided
20/08/2025
Type of registration
Prospectively registered

Titles & IDs
Public title
Helping New Parents Feel Good and Function Well After Childbirth: A Study Testing Text Messages to Support Mental Wellbeing
Scientific title
Postnatal Mental Wellbeing Support for Birthing Parents: A Randomised Controlled Trial of a Co-Designed Text Message Intervention within the Healthy Beginnings for HNE Kids Program
Secondary ID [1] 315049 0
Nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record
ACTRN12624000655549
ACTRN12624001439538
ACTRN12625000574448
This record is a sub-study of the linked study records above related to the Healthy Beginnings for HNE Kids program.

Health condition
Health condition(s) or problem(s) studied:
Parent mental wellbeing 338409 0
Condition category
Condition code
Public Health 334714 334714 0 0
Health promotion/education
Public Health 334715 334715 0 0
Health service research
Reproductive Health and Childbirth 334807 334807 0 0
Childbirth and postnatal care

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Healthy Beginnings for Hunter New England Kids (HB4HNEKids) is a digital health model of care delivered via mobile health (mHealth) text messages. This trial will specifically evaluate the impact of a new mental wellbeing module embedded within the HB4HNEKids program. The module includes 20 co-designed text messages delivered over five months, starting four weeks after childbirth. Content was developed using behaviour change theory and informed by focus groups and interviews with regional and rural parents and clinicians to ensure relevance, practicality, and theoretical rigour. Messages were pilot tested for acceptability, with feedback used to refine content. The module covers topics such as normalising emotional changes after childbirth, self-care and coping strategies, strengthening parent–infant connection, and how and when to seek additional mental health support.

All participants in the trial receive the standard HB4HNEKids program; those in the intervention group also receive the mental wellbeing module, while the control group receives the standard program only.

The HB4HNEKids program provides families with evidence-based, age- and stage-appropriate preventive health information from birth to five years. Content includes anticipatory guidance on child health and development, breastfeeding, nutrition, physical activity, movement behaviours, and family/carer wellbeing, as well as reminders for immunisation and health and development checks.

Families enrolled in HB4HNEKids receive short text messages (up to 160 characters) with embedded links to credible online resources, such as videos, fact sheets, websites and local support services. Messages are sent approximately once per week from birth to age three, and once per fortnight from ages three to five. Message delivery is monitored via SMS reports, and engagement with content is tracked using a URL analytics platform. Adherence to the intervention is assessed using these engagement metrics, opt-out rates, and follow-up Computer-Assisted Telephone Interviews (CATI) at 6 and 12 months postpartum to ask participants about message use and relevance.

Most messages are one-way and alpha-tagged with the program name; however, messages requesting feeding information are two-way to support tailoring. The intervention includes basic personalisation: using the child’s first name in some messages and adapting content to their current mode of milk feeding as well as specific age and stage milestones, to enhance relevance and user engagement.

Participants are provided with multiple opportunities to opt out of receiving the program throughout the intervention period (birth to 6 months postpartum). Unsubscribe links are sent via text messages when the child is 1, 3, 10, and 20 weeks old, and remain active for future use. Beyond the trial period, unsubscribe links are sent 2-4 times per year until the child turns five. An opt-out option is also available via the ‘Contact Us’ section of the program website, which includes the project team’s email address and phone number. Additionally, families can request to withdraw from the program during any interaction with the Child and Family Health Service.
Intervention code [1] 331654 0
Prevention
Intervention code [2] 331655 0
Behaviour
Intervention code [3] 331656 0
Lifestyle
Comparator / control treatment
The control group will receive the existing HB4HNEKids program, as described above, as part of usual service delivery provided by Child and Family Health Services.
Control group
Active

Outcomes
Primary outcome [1] 342371 0
Mental wellbeing
Timepoint [1] 342371 0
Immediately post-completion of intervention (at 6 months postpartum)
Secondary outcome [1] 450564 0
Parental self-efficacy
Timepoint [1] 450564 0
6 months postpartum.
Secondary outcome [2] 450565 0
Parent engagement
Timepoint [2] 450565 0
6 months postpartum
Secondary outcome [3] 450566 0
Opt-out rates
Timepoint [3] 450566 0
Data will be collected continuously throughout the intervention period.
Secondary outcome [4] 450567 0
Acceptability
Timepoint [4] 450567 0
6 months postpartum

Eligibility
Key inclusion criteria
Parents are eligible to participate if they:
1) Have a newborn baby
2) Own a mobile phone
3) Are eligible for HB4HNEKids as part of Child and Family Health service appointments within HNELHD
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Parents will be excluded if they:
1) Are not eligible for HB4HNEKids as part of Child and Family Health Services (CFHS)
2) Initially access CFHS located in a postcode within the Greater Newcastle sector (as these postcodes are involved in a separate ongoing RCT within the HB4HNEKids program).

Study design
Purpose of the study
Prevention
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/fax/computer
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation).
Participants will be randomly assigned in a 1:1 ratio to either the intervention or control group using block randomisation with variable block sizes of 2 and 4. The randomisation sequence will be computer-generated by an independent statistician using a random number function in Microsoft Excel.
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?


The people assessing the outcomes
Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis
A total of 406 birthing parents (203 per group) is targeted. Target follow-up completions are 122 (61 per group). This allows detection of a 2-point difference in SWEMWBS (SD 3.9), 80% power, a=0.05. This assumes a survey completion rate of 30%, informed by prior response patterns.

Trial outcomes will be analysed under an intention to treat framework. To assess effectiveness on health behaviours, we will compare between group difference using mixed logistic and linear regression models. The model will include fixed effects for parent demographics that are found to be significantly different between intervention arms to account for potential bias. Sub-group analyses based on parent characteristics will also be conducted to examine differential effects of the intervention arms against the outcome. All statistical tests will be 2 tailed with an alpha of 0.05.

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW

Funding & Sponsors
Funding source category [1] 319611 0
Government body
Name [1] 319611 0
Hunter New England Local Health District
Country [1] 319611 0
Australia
Primary sponsor type
Government body
Name
Hunter New England Local Health District
Address
Country
Australia
Secondary sponsor category [1] 322116 0
University
Name [1] 322116 0
University of Newcastle
Address [1] 322116 0
Country [1] 322116 0
Australia
Other collaborator category [1] 283612 0
Other Collaborative groups
Name [1] 283612 0
Hunter Medical Research Institute
Address [1] 283612 0
Country [1] 283612 0
Australia

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 318175 0
Hunter New England Human Research Ethics Committee
Ethics committee address [1] 318175 0
Ethics committee country [1] 318175 0
Australia
Date submitted for ethics approval [1] 318175 0
01/12/2023
Approval date [1] 318175 0
20/12/2023
Ethics approval number [1] 318175 0
2023/ETH02782

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 143358 0
A/Prof Rachel Sutherland
Address 143358 0
Hunter New England Local Health District, Population Health. Locked Bag 1, New Lambton NSW 2305
Country 143358 0
Australia
Phone 143358 0
+61 2 4924 6499
Fax 143358 0
Email 143358 0
Contact person for public queries
Name 143359 0
Nayerra Hudson
Address 143359 0
Hunter New England Local Health District, Population Health. Locked Bag 1, New Lambton NSW 2305
Country 143359 0
Australia
Phone 143359 0
+61 2 4924 6499
Fax 143359 0
Email 143359 0
Contact person for scientific queries
Name 143360 0
Rebecca Liackman
Address 143360 0
Hunter New England Local Health District, Population Health. Locked Bag 1, New Lambton NSW 2305
Country 143360 0
Australia
Phone 143360 0
+61 2 4924 6499
Fax 143360 0
Email 143360 0

Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment: Study protocol and information about linked studies can be provided upon reasonable request.



What supporting documents are/will be available?

No Supporting Document Provided


Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.