Multidisciplinary interventions to promote tummy time practice and developmental outcomes in infants: A scoping...

Tummy time is recommended to support early motor development and mitigate complications associated with prolonged supine positioning in infancy. Caregivers often struggle to meet recommended tummy time guidelines following hospital discharge. Although therapy-based interventions have been developed, their delivery approaches and outcomes have not been comprehensively mapped. This scoping review examined tummy time interventions in infants and evaluated their impact on developmental outcomes using the Theoretical Domains Framework (TDF). Following Joanna Briggs Institute methodology, five databases, ClinicalTrials.gov, and reference lists were searched for studies employing tummy time interventions initiated post-hospital discharge and published between January 1994 and January 2025. Two independent reviewers completed screening and data extraction, with interventions mapped to the TDF. Eighteen publications involving 386 infants were included and interventions were categorized as stimulus-based approaches, positional supports, structured dosage-based programs, or technology-assisted motor training. Stimulus-based approaches and positional supports were associated with immediate gains in tummy time tolerance, technology-assisted training produced short- to long-term gains in tummy time duration and prone locomotion, and structured dosage-based programs demonstrated improvements in motor development (Cohen's d 0.2-2.81). Reinforcement was the most consistently represented TDF domain (100%), while Beliefs About Consequences was least represented (17%). Findings highlight multidisciplinary intervention strategies that can improve tummy time tolerance, practice adherence, and motor development outcomes in typically developing and at-risk infants. Effectiveness varied by intervention type, population, and targeted outcomes, with greatest impact observed when behavioral strategies were purposefully aligned with specific outcomes, rather than incorporating a larger number of TDF domains.