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Development and nationwide implementation of a postdischarge responsive parenting intervention program for very
Martine Jeukens-Visser1, Karen Koldewijn1, Aleid G van Wassenaer-Leemhuis2
1Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands.
Insights
The TOP program, a responsive parenting intervention for very preterm (VPT) infants, has been successfully implemented nationwide in the Netherlands. It is now integrated into routine care, demonstrating high parental satisfaction.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Previous trials indicated the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants.
- Nationwide implementation was deemed justified based on prior evidence.
Purpose of the Study:
- To describe the development and nationwide implementation of the TOP program.
- To detail the three-phase process from preparation to full integration into routine care.
Main Methods:
- A 12-year implementation strategy involving preparation, pilot, and full-implementation phases.
- Securing funding, developing intervention strategies, increasing capacity, and incorporating systematic evaluations.
Main Results:
- The TOP program is now part of routine care in the Netherlands, reimbursed by all Dutch Healthcare Insurers.
- By 2018, interventionists increased to 91, with widespread hospital referrals, reaching 70% of the target population.
- Parental satisfaction with the TOP program is high.
Conclusions:
- The TOP program has been successfully scaled nationwide and integrated into standard care for very preterm infants.
- The long-term implementation demonstrates the program's sustainability and effectiveness in improving outcomes for VPT infants and their families.
Abstract:
A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006-2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010-2014), intervention strategies were developed for a real-world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full-implementation phase (2014-2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12-year implementation period, the TOP program forms part of routine care in the Netherlands.
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