Short summary

The FAMKO project examines whether an early and coordinated intervention can reduce inequality in health for vulnerable women and their children.

The FAMKO project is a collaboration between Familieambulatoriet, OUH and Odense Municipality (Family clinic and Municipality: FACAM).

Rationale

Most women wish to give their (unborn) child the best conditions during pregnancy and upbringing. Some women, however, have better opportunities to support the child both physically, mentally and socially than others. Pregnant women who struggle with psychosocial challenges during pregnancy have a higher risk of preterm birth, giving birth to a child with low birth weight and have a higher risk of complications during pregnancy both for mother and child. This can be caused by many factors such as an unhealthy diet, overweight, smoking, alcohol or drug abuse or severe psychosocial challenges. In the long run, the child's development and mental health can be affected if the quality of the attachment, care and stimulation during pregnancy and infancy are not optimal. An early and coordinated intervention to reduce inequality in health may be important for this group of vulnerable women.

The FACAM project is a randomized controlled trial with two study arms: intervention (FACAM) and care as usual (CAU). Pregnant women are randomized to receive either FACAM or CAU.

The FACAM intervention consists of assigning a support person to each pregnant woman in the intervention group. The support person will offer individualized support to the family depending on the needs of the family until the child starts school at age 6.  All participants in the intervention group will also receive an attachment based intervention (ABI) during pregnancy and the first months of the child's life.

The aim of the trial is to assess the effectiveness of FACAM to improve social functioning and integration, mother-child relationship, maternal health, maternal mental health, and the development and well-being of the child. Furthermore, the aim is to explore how participants and employees experience the intervention and how it affects the trajectory through pregnancy and the first year after the baby is born.

Description of the cohort

Participants are pregnant women and their children, categorized as antenatal care group 3 or 4, living in Odense and with a referral to Familieambulatoriet, OUH. Participants must be able to fill out questionnaires in Danish or English.

We plan to recruit 320 pregnant women from October 2018 to mid-2020 - 160 to FACAM and 160 to CAU.

Data and biological material

• Survey data 
• Observational data 
• Register data 
• Qualitative data

Collaborating researchers and departments

Department of Gynaecology and Obstetrics, Odense university hospital

• Professor, Ellen Aagaard Nøhr

Department of Health research, University College Lillebælt, IMK, Odense University Hospital, and Centre for Global Health, University of Southern Denmark

• Associate Professor, Docent, Dorthe Nielsen

VIVE - The Danish Center for Social Science Research, Copenhagen

• post.doc.Maiken Pontoppidan