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A Scoping Review of Multimodal, Dyadic Early Relational Health Interventions in NICUs in the United States
Umber Darilek1, Jasmine Graw, Laura Sisk
1Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Dr Darilek); School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Drs Graw, Sisk, Crawford, and McGlothen-Bell); Medical Sciences Library, Texas A&M University, College Station,Texas (Ms Lopez); and Dolph Briscoe Jr Library, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Ms Howe).
Insights
Early relational health (ERH) interventions in the NICU show promise for improving infant and family outcomes. Further research with larger sample sizes is needed to confirm these benefits.
Area of Science:
- Neonatal Intensive Care Unit (NICU) research
- Early Relational Health (ERH)
- Developmental Psychology
- Family-Centered Care
Background:
- Early relational health (ERH) interventions are crucial for mitigating toxic stress in infants within the Neonatal Intensive Care Unit (NICU).
- These interventions positively influence the developmental trajectories of vulnerable NICU populations.
Purpose of the Study:
- To systematically review the scientific literature on multimodal, dyadic ERH interventions implemented in US NICUs.
- To identify existing research and pinpoint gaps in the current body of knowledge.
Main Methods:
- Comprehensive literature search of major databases (PubMed, Scopus, CINAHL, PsycInfo) and gray literature.
- Inclusion criteria focused on English-language, original research of multimodal, dyadic ERH interventions in US NICUs.
- Data extraction included intervention characteristics, study design, and outcomes for infants and families.
Main Results:
- The review identified several multimodal, dyadic ERH interventions demonstrating positive outcomes for NICU infants and families.
- Evidence suggests improvements in relational health, and physical and mental health for both infants and parents.
- A need for further research with larger sample sizes and replication studies was highlighted.
Conclusions:
- ERH interventions hold significant promise for enhancing neurodevelopmental and behavioral outcomes in infants.
- These interventions positively impact maternal mental health.
- Implementation of ERH interventions into standard NICU services is recommended.
Background:
Early relational health (ERH) interventions can buffer toxic stress and improve the developmental trajectories of neonatal intensive care unit (NICU) infants.
Purpose:
The purpose was to examine the current state of the science related to multimodal, dyadic ERH interventions implemented in the NICU setting in the United States and identify gaps in the current literature.
Data Sources:
PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo were searched in November 2022 and November 2023 for original studies and conference proceedings from 1970 to present in the English language. Gray literature searches were performed in February 2023 and December 2023.
Study Selection:
English language, original research, with a focus on multimodal, dyadic ERH interventions that took place primarily in a NICU in the United States were included. Outcome measures could be related to implementation, relational health, or physical and/or mental health outcomes of parent and/or infant. Eighteen of 2021 reviewed articles met the inclusion criteria.
Data Extraction:
Data were extracted for author, year, intervention, purpose, methods, sample, paternal inclusion, dyadic components, non-dyadic components, and major outcomes/results and distilled for study characteristics, multimodal, dyadic intervention characteristics, and outcome measures.
Results:
Several multimodal dyadic interventions exist to aid ERH in the NICU, providing evidence of improved outcomes for infants and families. More research is required using higher sample sizes and replication studies.
Implications For Practice And Research:
ERH interventions show promise in improving neurodevelopmental, behavioral, and maternal mental health outcomes and should be considered for implementation into NICU services.
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