The Linking Loss development study: a coproduction programme to adapt and test a peer-led, group intervention that is inclusive of marginalised communities with mental health difficulties following early pregnancy loss

Development work question: Can a coproduction approach result in an adapted peer-led, group intervention for people who have experienced mental health difficulties following early pregnancy loss (EPL), and is inclusive of those from marginalised communities? Background: EPL before 24 weeks affects 15% of all pregnancies and is associated with increased mental health problems. Despite its high prevalence, those affected struggle to access psychological support compared with later pregnancy loss. Those from marginalised groups are often the most a risk of EPL and mental health difficulties, whilst also being those that experience the most barriers to accessing support. Peer-led models of care have high acceptability among those affected by EPL and marginalised communities, but research on their clinical and cost effectiveness, and model of inclusive delivery and implementation are lacking. Aims and Objectives: To develop an understanding of the experiences and needs of people who have experienced mental health difficulties following EPL, with a focus on those from Black, Asian and LQBTQIA+ communities. To use this data in a coproduction approach to develop a peer-led, group intervention, that can be tested for its acceptability and clinical and cost effectiveness in a future full PGfAR. Development work plan: WP1 aims to use a qualitative survey (n=200) and interviews (n=40) with people who have experienced EPL to understand their preferences around psychological support, as well as the barriers and facilitators to accessing it. Participants will be recruited via community groups and social media, and data will be analysed using framework analysis. WP2 aims to use a qualitative survey (n=100) and interviews (n=20) to understand the experiences of EPL professionals in the NHS and third sector in managing mental health difficulties as part of their role, with consideration of inclusive practice. Participants will be recruited via NHS Early Pregnancy Units as well as through social media, and data will be analysed using framework analysis. WP3 will involve a series of 8 coproduction workshops with experts by experience and practitioners that uses the data collected in WP1 and WP2 to develop a peer-led, group intervention to ensure it is inclusive of the experiences and needs of Black, Asian and LQBTQIA+ communities. Timelines for delivery: 24 months starting January 2025. Initial 4-months for study set up, 14-months for qualitative data collection (WP1 & 2), and a further overlapping 14-months for intervention coproduction (WP3), finishing with a final 3-months for write up and PGfAR submission. Anticipated Impact: The PDG will coproduce an inclusive, peer-led, group intervention for people who have experienced mental health difficulties following early pregnancy loss (EPL), that can be further developed and tested on a larger scale, which will inform our application to PGfAR to conduct a full-scale trial. Dissemination: We will coproduce creative ways to share our findings in newsletters, social media, peer-reviewed journals, practitioner magazines and conference presentations.