Overview of All Our Families Methods

 

All Our Families (formerly All Our Babies) includes over 3200 women recruited during pregnancy, some of whom participated in a group prenatal care program (Centering Pregnancy), and some provided blood samples and cord blood. All Our Families mothers have described their experiences and lifestyle during pregnancy, as new parents, as parents of toddlers, preschoolers and now, as the All Our Families children begin formal schooling. Participating families have completed routine questionnaires at time points relevant for understanding child development and family well being and they also participate in important topical questionnaires when major events happen such as the H1N1 outbreak (2009) and the Calgary Flood (2013). Some of our research requires that we do detailed assessments of children, so some families also contribute by coming to our research centre for developmental assessments. We are now working on our school aged questionnaires so we can learn more about how children and families are doing in the ‘middle years’ where screen time, recreation, sleep, food habits, friendships, school work and family play a key role in keeping children and families healthy. We hope to continue collecting data on All Our Families for a long time to come!

 

Examples of our Research Questions

- What proportion of pregnant women living in Calgary display symptoms of depression and anxiety disorder in early pregnancy, late pregnancy, and at 4 months postpartum?

- What proportion of pregnant women living in Calgary report low social support and high stress levels at early pregnancy, late pregnancy, and at 4 months postpartum?

- What are the current rates of low birth weight, small for gestational age, and preterm birth among infants born in Calgary?

- What are the current barriers and facilitators to accessing routine prenatal care in Calgary?

 

Secondary Research Questions

- What impact does access to routine prenatal care have on maternal depression, anxiety, social support, stress, breastfeeding, parenting, and infant birth outcomes?

- What are the rates of breastfeeding, attendance at well child visits, child immunizations, uptake of parenting classes or supports and identification of a paediatric provider among mothers with new babies in Calgary?

 

Collection at timepoints-page-001

Using standardized scales, information about demographics, mental health, lifestyle, pregnancy, parenting, child development, family life and service use was collected in an effort to identify early markers of later outcomes. Future follow up through the school years aims to investigate sleep, activity, injury, recreation, child well-being, family life, time crunch, stress, social support and community supports.

 

 

Characteristic Overview -page-001When comparing the characteristics of women recruited into the All Our Families cohort in 2010, we found that the demographics were very similar to those found in Calgary, Alberta and Canada, with the exception of mean income.

 

Inclusion Criteria

 - Able to communicate in written and spoken English
 - Less than 24 weeks pregnant at enrolment 
 - Accessing prenatal care in Calgary
 

Data Collection

- Data was collected from May 2008-August 2010

- Participants completed two questionnaires during pregnancy and follow-up questionnaires at 4 months, and at 1, 2, 3 and 5 years post-partum. For those women who consented, questionnaire data was linked to administrative data and birth records to include select maternal and infant outcomes.

- Participants were provided with postage paid return envelopes for remittance of completed questionnaires. Once the questionnaires were received, participants were provided with a gift certificate.  

- Completed questionnaires are entered into a secure Teleform database by research assistants and trainees. Reliability of data entry is ensured through the TeleForm verification software where each variable must be confirmed twice. The electronic data capture is programmed to optimize the input of valid and reliable data using value range control and skip patterns.

- Information from special laboratory visits are also be entered into the secure TeleForm database.

- Research questions and methods are approved by the Conjoint Medical Ethics board. All researchers, trainees and staff who access the data sign confidentiality agreements and data access is strictly controlled.

 

Questionnaires

Questionnaires consisted of investigator derived questions and standardized scales. To develop new questionnaires the All Our Families team convenes content and research experts and gains consensus on key questions to ask.

 - Maternal depression: Edinburgh Postnatal Depression Scale
 - Maternal anxiety: Speilberger State Anxiety Scale
 - Maternal social support: MOS Social Support Scale
 - Maternal stress: Perceived Stress Scale
 - T-ACE Screen for alcohol consumption risk
 - Parenting: Parenting Morale Index
 - Breastfeeding: MCH Feeding Scale
 - Maternal optimism: Life-Orientation Revised (optimism) Scale
 - Maternal health: SF-12

(Click image to enlarge)