Motivational interviewing pilot randomized trial targeting ethnically-, linguistically-, and racially-diverse...

We evaluated feasibility, acceptability, and fidelity of motivational interviewing (MI) designed to increase neonatal intensive care unit (NICU) presence among ethnically/linguistically/racially diverse mothers. We also assessed study design feasibility to inform a larger, future randomized controlled trial.

We randomized 95 mothers to receive MI (intervention condition) or treatment as usual (control condition) during their baby's Level IV NICU admission. Eligibility criteria included mothers' adult age, English- and/or Spanish-language proficiency, and having a NICU-hospitalized infant. Using single-blind methodology, we assigned mothers to receive MI (n = 47) or treatment-as-usual (n = 42). Mothers rated intervention satisfaction, the extent to which MI motivated their NICU presence, and their openness to additional MI intervention. We evaluated MI fidelity to further assess MI feasibility.

Of 131 eligible mothers, 72.5% enrolled. Motivational interviewing-arm mothers received 1-6 weekly MI sessions. Regarding MI-arm mothers, 100% agreed to subsequent MI intervention, and 90% reported strong MI satisfaction. Eighty-seven percent of mothers reported that MI motivated them to be present in the NICU. Motivational interviewing interventionists achieved expert proficiency for 72.7% of coded MI sessions and basic competency for the remaining 27.3% of coded sessions. Mothers' MI perceptions did not differ by ethnic or linguistic groups.

Motivational interviewing was feasible and highly acceptable across all ethnic/linguistic/racial groups, making MI a promising intervention to increase maternal NICU presence among mothers from traditionally marginalized groups. Future research should evaluate the extent to which MI can increase maternal NICU presence and enhance infant (e.g., medical/developmental) and maternal (e.g., postpartum depression, infant bonding) outcomes.