{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:51:26Z","timestamp":1784328686580,"version":"3.55.0"},"reference-count":52,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T00:00:00Z","timestamp":1587168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000380","name":"Guy's and St Thomas' Charity","doi-asserted-by":"publisher","award":["MAJ141101"],"award-info":[{"award-number":["MAJ141101"]}],"id":[{"id":"10.13039\/501100000380","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Social adversity can significantly influence the wellbeing of mothers and their children. Maternal health may be improved through strengthened support networks and better health literacy. Health improvement at the population level requires optimizing of the collaboration between statutory health services, civic organizations (e.g., churches, schools), as well as community groups and parents. Two key elements in improving community engagement are co-production and community control. This study evaluated a co-produced and community-led project, PACT (Parents and Communities Together), for mothers in a deprived south London borough. The project offered social support and health education. Intended effects were improvements in mental health, health literacy, and social support, assessed by standardized measures in a pre-post design. Sixty-one mothers consented to take part in the evaluation. Significant improvements were found in mental health measures, in health literacy, for those with low literacy at baseline, and in overall and some specific aspects of social support. Satisfaction with the project was high. We found that the project engaged local populations that access statutory health services relatively less. We conclude that community-organized and community-led interventions in collaboration with statutory health services can increase accessibility and can improve mothers\u2019 mental health and other health-related outcomes.<\/jats:p>","DOI":"10.3390\/ijerph17082795","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T04:49:38Z","timestamp":1587444578000},"page":"2795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Can a Community-Led Intervention Offering Social Support and Health Education Improve Maternal Health? A Repeated Measures Evaluation of the PACT Project Run in a Socially Deprived London Borough"],"prefix":"10.3390","volume":"17","author":[{"given":"June","family":"Brown","sequence":"first","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Luderowski","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Namusisi-Riley","sequence":"additional","affiliation":[{"name":"Citizens UK, 112 Cavell Street, London E1 2JA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imogen","family":"Moore-Shelley","sequence":"additional","affiliation":[{"name":"Citizens UK, 112 Cavell Street, London E1 2JA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bolton","sequence":"additional","affiliation":[{"name":"Citizens UK, 112 Cavell Street, London E1 2JA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-1861","authenticated-orcid":false,"given":"Derek","family":"Bolton","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,18]]},"reference":[{"key":"ref_1","unstructured":"Allen, G. (2011). The Allen Report. Early Intervention: The Next Steps, an Independent Report to Her. Majesty\u2019s Government by Graham Allen MP, The Stationery Office."},{"key":"ref_2","unstructured":"Chief Medical Officer (2013). Our Children Deserve Better: Prevention Pays: Annual Report of the Chief Medical Officer 2012, Department of Health and Social Care."},{"key":"ref_3","unstructured":"The Wave Trust (2013). From Conception to Age 2\u2014The Age of Opportunity, The Wave Trust."},{"key":"ref_4","unstructured":"Marmot, M. (2010). Fair Society, Healthy Lives. Strategic Review of Health Inequalities in England Post-2010. The Marmot Review, Institute of Health Equity."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/bmb\/ldr047","article-title":"Postnatal depression and its effects on child development: A review of evidence from low- and middle-income countries","volume":"101","author":"Parsons","year":"2011","journal-title":"Br. Med. Bull."},{"key":"ref_6","unstructured":"Maternal Health (2016). An Executive Summary for the Lancet\u2019s Series. Lancet, 388, 1\u20138. Available online: http:\/\/www.thelancet.com\/pb\/assets\/raw\/Lancet\/stories\/series\/maternal-health-2016\/mathealth2016-exec-summ.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/0029-7844(94)00449-N","article-title":"Chronic stressors, social support, and depression during pregnancy","volume":"85","author":"Potvin","year":"1995","journal-title":"Obstet. Gynecol."},{"key":"ref_8","first-page":"388","article-title":"First?time mothers: Social support, maternal parental self?efficacy and postnatal depression","volume":"21","author":"McCarthy","year":"2011","journal-title":"J. Clin. Nurs."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1093\/heapro\/15.3.259","article-title":"Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century","volume":"15","author":"Nutbeam","year":"2000","journal-title":"Health Promot. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1093\/heapro\/dax015","article-title":"Improving health literacy in community populations: A review of progress","volume":"33","author":"Nutbeam","year":"2017","journal-title":"Health Promot. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"m693","DOI":"10.1136\/bmj.m693","article-title":"Health equity in England: The Marmot review 10 years on","volume":"368","author":"Marmot","year":"2020","journal-title":"BMJ"},{"key":"ref_12","unstructured":"(2008). Community Engagaement to Improve Health; Public Health Guideline (PH9), National Institute of Clinical Excellence."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1093\/pubmed\/fdv017","article-title":"Community organizing and community health: Piloting an innovative approach to community engagement applied to an early intervention project in south London","volume":"38","author":"Bolton","year":"2015","journal-title":"J. Public Health"},{"key":"ref_14","unstructured":"(2018, May 08). Citizens UK. Available online: http:\/\/www.citizensuk.org\/."},{"key":"ref_15","unstructured":"(2018, May 08). King\u2019s Health Partners. Available online: http:\/\/www.kingshealthpartners.org\/."},{"key":"ref_16","unstructured":"Alinsky, S.D. (1989). Reveille for Radicals, Vintage Books."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ganz, M. (2011). Public Narrative, Collective Action, and Power. Accountability Through Public Opinion: From Inertia to Public Action, The World Bank.","DOI":"10.1596\/9780821385050_CH18"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bolton, D., Khazaezadeh, N., Carr, E., Bolton, M., Platsa, E., Moore-Shelley, I., Luderowski, A., Demilew, J., and Brown, J. (2020). Evaluation of community led interventions in South London: How much standardization is possible?. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072523"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.socscimed.2010.11.027","article-title":"Access to primary mental health care for hard-to-reach groups: From \u2018silent suffering\u2019 to \u2018making it work\u2019","volume":"72","author":"Kovandzic","year":"2011","journal-title":"Soc. Sci. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/1467-9515.00300","article-title":"Consultation, for a Change? Engaging Users and Communities in the Policy Process","volume":"36","author":"Cook","year":"2002","journal-title":"Soc. Policy Adm."},{"key":"ref_21","unstructured":"Hibbins, J. (2019, January 28). The Question Mental Health Services Need to Ask before Labeling a Patient \u2018Too Difficult\u2019. Available online: https:\/\/themighty.com\/2016\/07\/why-mental-health-providers-shouldnt-say-difficult-to-engage\/."},{"key":"ref_22","unstructured":"Pharoah, R., Hale, T., and Lee, N. (2010). Uncovering Community: Chinese & Latin Americans in Southwark, Southwark Council."},{"key":"ref_23","unstructured":"Pharoah, R., and Hopwood, O. (2013). Families & Hardship: In New and Established Communities in Southwark, Southwark Council."},{"key":"ref_24","unstructured":"Office for National Statistics (1991). Standard Occupational Classification. Volume 3. The National Statistics Socio-Economic Classification, HMSO."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A New Depression Diagnostic and Severity Measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatr. Ann."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1370\/afm.405","article-title":"Quick Assessment of Literacy in Primary Care: The Newest Vital Sign","volume":"3","author":"Weiss","year":"2005","journal-title":"Ann. Fam. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1001\/jama.2010.896","article-title":"Can This Patient Read and Understand Written Health Information?","volume":"304","author":"Powers","year":"2010","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Putnam, R.D., Leonardi, R., and Nanetti, R.Y. (1994). Making Democracy Work: Civic Traditions in Modern Italy, Princeton University Press.","DOI":"10.1515\/9781400820740"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1093\/wbro\/15.2.225","article-title":"Social Capital: Implications for Development Theory, Research, and Policy","volume":"15","author":"Woolcock","year":"2000","journal-title":"World Bank Res. Obs."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.2105\/AJPH.2010.300113","article-title":"Advancing the Science of Community-Level Interventions","volume":"101","author":"Trickett","year":"2011","journal-title":"Am. J. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1046\/j.1365-2648.1999.01041.x","article-title":"Social support: Factors to consider when designing studies that measure social support","volume":"29","author":"Hutchison","year":"1999","journal-title":"J. Adv. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/BF00918174","article-title":"Preliminary development of a scale of social support: Studies on college students","volume":"9","author":"Barrera","year":"1981","journal-title":"Am. J. Community Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF00927113","article-title":"Family and peer social support as specific correlates of adolescent depressive symptoms","volume":"20","author":"Barrera","year":"1992","journal-title":"J. Abnorm. Child. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/bin.2360040104","article-title":"Acceptability of behavioral staff management techniques","volume":"4","author":"Davis","year":"1989","journal-title":"Behav. Interv."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol. Bull."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Gask, L., Bower, P.J., Lamb, J., Burroughs, H., Chew-Graham, C., Edwards, S., Hibbert, D., Kovandzic, M., Lovell, K., and Rogers, A. (2012). Improving access to psychosocial interventions for common mental health problems in the United Kingdom: Narrative review and development of a conceptual model for complex interventions. BMC Health Serv. Res., 12.","DOI":"10.1186\/1472-6963-12-249"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Memon, A., Taylor, K., Mohebati, L.M., Sundin, J., Cooper, M., Scanlon, T., and De Visser, R.O. (2016). Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: A qualitative study in Southeast England. BMJ Open, 6.","DOI":"10.1136\/bmjopen-2016-012337"},{"key":"ref_39","unstructured":"Office of National Statistics (2016). 2011 Census Aggregate Data, UK Data Service. June 2016 ed."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Hepgul, N., King, S., Amarasinghe, M., Breen, G., Grant, N., Grey, N., Hotopf, M., Moran, P., Pariante, C.M., and Tylee, A. (2016). Clinical characteristics of patients assessed within an Improving Access to Psychological Therapies (IAPT) service: Results from a naturalistic cohort study (Predicting Outcome Following Psychological Therapy; PROMPT). BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-0736-6"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s00127-014-0900-6","article-title":"How equitable are psychological therapy services in South East London now? A comparison of referrals to a new psychological therapy service with participants in a psychiatric morbidity survey in the same London borough","volume":"49","author":"Brown","year":"2014","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"365","DOI":"10.3399\/bjgp10X501877","article-title":"Can a self-referral system help improve access to psychological treatments?","volume":"60","author":"Brown","year":"2010","journal-title":"Br. J. Gen. Pract."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Brown, J.S.L., Evans-Lacko, S., Aschan, L., Henderson, M.J., Hatch, S.L., and Hotopf, M. (2014). Seeking informal and formal help for mental health problems in the community: A secondary analysis from a psychiatric morbidity survey in South London. BMC Psychiatr., 14.","DOI":"10.1186\/s12888-014-0275-y"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1177\/1049732315591483","article-title":"Exploring Professional Help-Seeking for Mental Disorders","volume":"26","author":"Savage","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1177\/0020764009357400","article-title":"How black African and white British women perceive depression and help-seeking for this problem: A pilot vignette study","volume":"57","author":"Brown","year":"2011","journal-title":"Int. J. Soc. Psychiatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.genhosppsych.2013.04.006","article-title":"Standardization of the depression screener Patient Health Questionnaire (PHQ-9) in the general population","volume":"35","author":"Kocalevent","year":"2013","journal-title":"Gen. Hosp. Psychiatr."},{"key":"ref_47","unstructured":"Public Health England (2017). Commissioning for Value, Mental Health and Dementia Pack, NHS Southwark CCG."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s10865-019-00046-z","article-title":"Cognitive behavioral therapy for primary care depression and anxiety: A secondary meta-analytic review using robust variance estimation in meta-regression","volume":"42","author":"Zhang","year":"2019","journal-title":"J. Behav. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1037\/bul0000015","article-title":"The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis","volume":"141","author":"Johnsen","year":"2015","journal-title":"Psychol. Bull."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1007\/s00127-017-1421-x","article-title":"Low emotion-oriented coping and informal help-seeking behaviour as major predictive factors for improvement in major depression at 5-year follow-up in the adult community","volume":"52","author":"Rodgers","year":"2017","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1017\/S2045796013000504","article-title":"Social support in depression: Structural and functional factors, perceived control and help-seeking","volume":"22","author":"Kleinberg","year":"2013","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_52","unstructured":"Luderowski, A., Lyons, S., and Brown, J.S.L. Qualitative feedback from Mumspace, a co-produced community intervention in a socially deprived area, in preparation."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2795\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:45:05Z","timestamp":1760363105000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,18]]},"references-count":52,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["ijerph17082795"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17082795","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,18]]}}}