Effectiveness of Comprehensive Health-literacy And Relaxing Music (CHARM) intervention on pregnancy-related anxiety among low-risk primigravid women: A randomized controlled trial

Pregnancy-related anxiety commonly occurs among first-time pregnant women, carrying an increased risk of harmful effects to both mother and the growing fetus or newborns. This study aims to assess the effectiveness of a Comprehensive Health-literacy And Relaxing Music (CHARM) intervention compared with two other stand-alone interventions (relaxing music–only intervention, comprehensive health literacy–only intervention) and a standard care group on pregnancy-related anxiety. We conducted an open-label, parallel four-arms, randomized controlled trial among 128 low-risk primigravid women, who were randomly allocated to one of the four groups (1:1:1:1). Women were assigned with a separate web-based link for the three interventions, which were provided for 4 weeks. The pregnancy-related anxiety was measured using the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) assessed at baseline and post-intervention. After the 4-week intervention, a repeated-measures analysis of variance showed significant mean changes, and interaction effect between the groups on pregnancy-related anxiety levels (F(3,124) = 5.6, p =.001, η_p² =.12); CHARM intervention significantly reduced pregnancy-related anxiety levels in comparison with other three groups including the standard care group. The CHARM intervention was thus found to be effective in reducing pregnancy-related anxiety levels, and may be recommended for pregnant women for promoting their perinatal mental well-being.