Promoting Equity in Parent Presence and Participation in Neonatal Intensive Care: Protocol for a Prospective Cohort...

Area of Science:

• Neonatal intensive care
• Perinatal health
• Health equity

Background:

• Parents of preterm infants face significant barriers to presence and participation in neonatal intensive care units (NICUs).
• These barriers are often more profound for parents from marginalized backgrounds, contributing to health inequities.
• Parent presence and participation (PPP) is crucial for improving clinical outcomes and neurodevelopment in preterm infants.

Purpose of the Study:

• To longitudinally identify barriers and facilitators of PPP across diverse sociodemographic groups.
• To determine the impact of PPP on infant clinical outcomes and neurodevelopment, and the role of parent-infant responsiveness.
• To examine how PPP moderates the relationship between infant stress and outcomes.

Main Methods:

• Prospective cohort study of 375 parents of preterm infants (<32 weeks' gestational age).
• Daily surveys on NICU time and caregiving, plus regular surveys on barriers, facilitators, stress, and staff engagement.
• Collection of infant clinical data, invasive procedure records, nursing PPP documentation, and assessments of maternal-infant responsiveness, motor performance, and neurodevelopment.

Main Results:

• Study funding awarded August 2024; data collection and analysis are ongoing.
• Expected completion of data collection and analysis by July 2029.

Conclusions:

• Identifying barriers and facilitators of PPP is essential for developing targeted interventions.
• Interventions can reduce system-level barriers and enhance facilitators to increase PPP.
• Increasing PPP can promote health equity for diverse families with preterm infants.