King's College London

Research portal

Multicountry study protocol of COCOON: COntinuing Care in COVID-19 Outbreak global survey of New, expectant, and bereaved parent experiences

Research output: Contribution to journalArticlepeer-review

Siobhan A. Loughnan, Rupesh Gautam, Sergio A. Silverio, Frances M. Boyle, Jillian Cassidy, David Ellwood, Caroline S.E. Homer, Dell Horey, Susannah H. Leisher, Francine deMontigny, Margaret Murphy, Keelin O'Donoghue, Paula Quigley, Claudia Ravaldi, Jane Sandall, Claire Storey, Alfredo Vannacci, Alyce N. Wilson, Vicki Flenady, and on behalf of the COCOON Global Collaboration

Original languageEnglish
Article numbere061550
Pages (from-to)1-12
JournalBMJ Open
Issue number9
Accepted/In press25 Jul 2022
Published5 Sep 2022

Bibliographical note

Funding Information: This study is funded by investigator VF and the Mater Research Institute, The University of Queensland, Brisbane, Australia. SAS and JS (King’s College London) are supported by the National Institute for Health Research Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. SAS is also in receipt of a Personal Doctoral Fellowship Award from the NIHR ARC South London Capacity Building Theme; and JS is also supported by the NIHR Senior Investigator Awards. The training and infrastructure of the PUDDLES Global Collaboration on Perinatal Bereavement is supported by the King’s College London Global Engagement Partnership Fund successfully awarded to JS (ref: PF2021_Mar_039). Publisher Copyright: © 2022 BMJ Publishing Group. All rights reserved.


King's Authors


Introduction Globally, the COVID-19 pandemic has significantly disrupted the provision of healthcare and efficiency of healthcare systems and is likely to have profound implications for pregnant and postpartum women and their families including those who experience the tragedy of stillbirth or neonatal death. This study aims to understand the psychosocial impact of COVID-19 and the experiences of parents who have accessed maternity, neonatal and bereavement care services during this time.

Methods and analysis An international, cross-sectional, online and/or telephone-based/face-to-face survey is being administered across 15 countries and available in 11 languages. New, expectant and bereaved parents during the COVID-19 pandemic will be recruited. Validated psychometric scales will be used to measure psychosocial well-being. Data will be analysed descriptively and by assessing multivariable associations of the outcomes with explanatory factors. In seven of these countries, bereaved parents will be recruited to a nested, qualitative interview study. The data will be analysed using a grounded theory analysis (for each country) and thematic framework analysis (for intercountry comparison) to gain further insights into their experiences.

Ethics and dissemination Ethics approval for the multicountry online survey, COCOON, has been granted by the Mater Misericordiae Human Research Ethics Committee in Australia (reference number: AM/MML/63526). Ethics approval for the nested qualitative interview study, PUDDLES, has been granted by the King’s College London Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference number: HR-19/20-19455) in the UK. Local ethics committee approvals were granted in participating countries where required. Results of the study will be published in international peer-reviewed journals and through parent support organisations. Findings will contribute to our understanding of delivering maternity care services, particularly bereavement care, in high-income, lower middle-income and low-income countries during this or future health crises.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454