Social support and education groups for single mothers: a randomized controlled trial of a community-based program

Abstract

Background: Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting.

Methods: We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting.

Results: Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood (p < 0.01, standardized effect = 0.55) and self-esteem (p < 0.05, standardized effect = 0.29) compared with mothers in the control group; scores for the other 2 measures did not differ between the groups. Growth curve analysis of program effects over the follow-up period showed improvement in all 4 outcomes, with no significant difference between the intervention and control groups.

Interpretation: This community-based program of group sessions offering social support and education to low-income single mothers had positive short-term effects on mood and self-esteem but not on social support and parenting. Longer follow-up showed attenuation of these effects.

Fig. 1: Flow of participants through the trial. R = randomization. *Mothers in the intervention arm attended 10 weekly group sessions (1.5 hours per week) during which they received social support and education; mothers in the control arm were given a standard list of community resources and the option to attend group sessions at the end of the follow-up period.

Fig. 2: Growth curves for changes in depressive mood (A), self-esteem (B), social support (C) and parenting (D). CES-D = Center for Epidemiologic Studies Depression Scale. For details about the scales and score ranges see the online appendix at www.cmaj.ca/cgi/content/full/173/12/1451/DC1.