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‘I was a bit sceptical’: The RELAX study’s public involvement – what we’ve done and how it feels to be involved

In this co-produced blog, Mary Newburn from the ARC’s maternity and perinatal mental health theme shares reflections and insights about public involvement in the RELAX study, which is testing a form of ‘brain training’ designed to reduce anxiety in pregnant women and new mothers.

About the RELAX study and its public involvement

The REduce Levels of AnXiety (RELAX) study is a randomised controlled trial testing a form of ‘brain training’ designed to reduce anxiety in pregnant women and new mothers — an approach that has already been successful with non-pregnant people.

In the study, participants who are randomised to receive the RELAX training, as well as receiving their usual maternity care, are invited to listen to short scenarios about everyday life and pregnancy. The training is designed to help participants learn to resolve these scenarios positively and imagine themselves in the positive outcome, and by doing so gradually reduce patterns of negative thinking. Participants in the control arm of the study have their usual maternity care.

In the early days of planning the study, Professor Colette Hirsch, clinical psychologist and the study’s chief investigator, talked with community and maternity groups, including the King’s College Hospital maternity voices partnership (MVP) and Parents and Communities Together (PACT) in Southwark. Colette also approached ARC South London’s maternity and perinatal mental health theme public advisory group, which is led by Mary Newburn. Mary became a co-applicant and the public involvement lead for the study.

Once the study successfully gained funding from the NIHR, the RELAX team held two online engagement workshops and PACT hosted a face-to-face introduction with lunch, aimed at women who had experienced worry or anxiety during pregnancy. Many women talked about how disabling their anxiety in pregnancy had been, and how it made their lives miserable. A diverse public advisory group was created made up of women who had attended one of these events, plus representatives from maternity charities and networks.

The RELAX team’s innovative and responsive approaches to public involvement:

What difference has public involvement made?

Public advisers have tested the platform used for the study training sessions, commented on the length of the training sessions, the introductory text, the scenarios of everyday situations, the logo and other graphics. In response to feedback, researchers have:

“I provided feedback on the wording of the scenarios and on marketing materials. Also, spreading the word about the study and distributing fliers in local libraries, talking about the study in a local children’s centre and schools, and via WhatsApp and Facebook.”

Lola Alimzhanova — Public adviser

Motivation and experiences of public advisers

We asked the public advisers what motivated them to be involved in the RELAX study:

“As someone who experienced anxiety during pregnancy, I wanted to contribute towards the study so I can make a difference to future pregnant women.”

Public adviser

“I was a bit sceptical regarding the method itself because I wasn’t sure how it could reduce anxiety and worry through watching videos and how it could help to reframe thoughts in a positive way since they are so ingrained in our thought process and became part of our identity. … But after learning more about the study, it made a lot of sense.”

Public adviser

Service user contributions – the highs and lows

We asked those contributing how it felt to be advising the researchers. A large majority of the feedback was positive:

“The whole team always made me feel valued … I always felt listened to and respected.”

Public adviser

“I’ve found the study content fascinating and I’ve really enjoyed being able to input into something that I honestly believe could make a real difference with so many women.”

Siobhean McCarthy-Perham — Public adviser

“It makes me feel like I’m really helping, being active in the involvement, and everyone always welcoming your thoughts and ideas.”

Abi — Public adviser

“Receiving posters, cards and the RELAX-branded merchandise (water bottle and pens) made me feel valued; it helped to strengthen my passion for the study. … it brings the study to life.”

Michelle Howard — Public adviser

“It is a great opportunity to have a voice. … As a stay-at-home mother of three it is extremely hard to be active and participate in non-children-related work. By providing a crèche at the first event and funds for childcare during the meetings, the RELAX team makes sure our voices are heard.”

Public adviser

Public contributors have enjoyed learning about research processes, but there have also been some frustrations:

“It surprised me how long ethics can take to approve and that it is very specific in what is approved and what is not.”

Public adviser

Potential negative consequences of involvement

Prompted during the co-production planning, we asked, ‘Has any aspect of the involvement been triggering, and if so, did you feel supported or know how to get support?’ Several people were reminded of stress and anxieties they had suffered. One who had tested the training said that involvement ‘did bring back some difficult memories, but I also felt empowered to process them in a different way’.

“I have not found the study to be triggering, but if there have been difficult conversations it has felt very supported and in a safe trusted place. I know who to contact for additional support.”

Public adviser

We also asked about any barriers to involvement. Research, and its jargon, can be especially complex for people whose mother-tongue is not English. One such person said: ‘So far it is okay, my barrier is just sometimes I feel I don’t belong, but the team always welcome me, and is happy to hear my comments.’

“The overall barrier to participate in research is lack of time whether you are in a full-time job or a full-time parent. As a result, public involvement is under represented by different ethnic groups, economic backgrounds etc.”

Public adviser

Nuts and bolts of public involvement

Some earlier work has emphasised the importance of reciprocal benefits for public members, in addition to fair remuneration. Advisers to RELAX value learning more about research and other research involvement opportunities. They also spoke about enjoying intellectually rewarding work while juggling domestic commitments, and gaining personal confidence. Payment of childcare costs and crèche facilities are much appreciated.

“I was given a very good introduction to the study, all answers to my questions were provided and I have been offered appropriate training opportunities. … I feel service user expenses were very well explained and paid in a timely manner.”

Public adviser

“We have a WhatsApp group and emails are replied to promptly.”

Public adviser

“The communication has been outstanding. We know so much about the progress of the study.”

Public adviser

Final thoughts

The RELAX study began in February 2022, but could not open to recruitment until June 2023, so the set-up and preparation period has been lengthy. Despite the slow start, which could have been demoralising, public involvement has been a positive experience. It has made a difference to many aspects of the delivery of the study, if not its fundamental design, and has generated ‘community’ recruitment, via social media publicity and distribution of posters and fliers.

As well as benefiting the study, public involvement has been a positive experience for the public advisers who feel valued, well supported and rewarded for their contributions. They feel highly motivated by the subject of the study and the intervention being tested.

About the authors

• Mary Newburn — RELAX public involvement lead
• Brittannia Volkmer — RELAX trial coordinator
• Abi — RELAX public adviser
• Simi Bansal — RELAX public partner and a doctor working in obstetrics
• Siobhean McCarthy-Perham — RELAX public adviser
• Rachael Leonard — NCT charity representative

Find out more

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  Visit the RELAX study website — or email ‘subscribe to newsletter’ to relaxstudy@kcl.ac.uk
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  Follow on Instagram and Facebook
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  To discuss public involvement in maternity research, email: mary.1.newburn@kcl.ac.uk
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  RELAX adopted project page — ARC South London
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  RELAX team report: reflections and tips on public involvement (December 2025)

Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.