Many researchers have tested in-hospital interventions to reduce the incidence of developmental problems in preterm infants. Although many have had positive short-term effects, relatively little is known about their long-term effects, the relative advantages of different interventions, their effects on parenting, or which infants benefit most from which interventions. This study will examine the short-and long-term effects of 2 maternally administered interventions for very-low-birthweight (VLBW) preterms on infant health and development, maternal psychological well being, and the maternal-child relationship, in comparison with a control group and with each other. The 2 interventions have been shown to be safe and have positive immediate effects for preterms: the auditorytactile-visual-vestibular (ATW) intervention and kangaroo care. Administering 1 of these interventions will allow the mother to assume a specific role in the care of her infant in the hospital. Comparing the interventions will enable us to determine the relative importance of the direct effects of the interventions on the infant and the indirect effects through the mother. 380 VLBW preterms and their mothers will be recruited. Using a 3-group design, they will be randomly assigned to the ATW intervention, kangaroo care, or an attention control group. Intervention nurses will instruct mothers in the intervention appropriate for their group and support them in administering it during hospitalization. Mothers will continue the intervention at home until the infant is 2 months corrected age. Baseline data will be collected at enrollment. Outcome data will be collected at hospital discharge and 2 months to determine effects immediately after the intervention and at 6 and 12 months corrected age to determine if the intervention effects persist after the conclusion of the intervention and affect the mother-infant relationship and infant health and development. Infant health and development will be measured by the length of hospitalization, growth, occurrence of health problems, and the Bayley II assessment. Maternal psychological well being will be measured using depressive symptoms, anxiety, posttraumatic stress symptoms, worry about child health, and parenting stress. The maternal-child relationship will be measured using videotapes of mother-infant interaction, the HOME Inventory, and maternal perception of child vulnerability. Cost-effectiveness of the interventions will also be determined.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR009418-05
Application #
7459611
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Mann Koepke, Kathy M
Project Start
2005-09-30
Project End
2010-06-30
Budget Start
2008-07-01
Budget End
2009-06-30
Support Year
5
Fiscal Year
2008
Total Cost
$553,238
Indirect Cost
Name
Duke University
Department
Type
Schools of Nursing
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Gondwe, Kaboni W; White-Traut, Rosemary; Brandon, Debra et al. (2017) The role of sociodemographic factors in maternal psychological distress and mother-preterm infant interactions. Res Nurs Health 40:528-540
Tully, Kristin P; Holditch-Davis, Diane; White-Traut, Rosemary C et al. (2016) A Test of Kangaroo Care on Preterm Infant Breastfeeding. J Obstet Gynecol Neonatal Nurs 45:45-61
Santos Jr, Hudson; Yang, Qing; Docherty, Sharron L et al. (2016) Relationship of Maternal Psychological Distress Classes to Later Mother-Infant Interaction, Home Environment, and Infant Development in Preterm Infants. Res Nurs Health 39:175-86
Garfield, Lindsey; Holditch-Davis, Diane; Carter, C Sue et al. (2015) Risk factors for postpartum depressive symptoms in low-income women with very low-birth-weight infants. Adv Neonatal Care 15:E3-8
Holditch-Davis, Diane; Santos, Hudson; Levy, Janet et al. (2015) Patterns of psychological distress in mothers of preterm infants. Infant Behav Dev 41:154-63
Holditch-Davis, Diane; White-Traut, Rosemary C; Levy, Janet A et al. (2014) Maternally administered interventions for preterm infants in the NICU: effects on maternal psychological distress and mother-infant relationship. Infant Behav Dev 37:695-710
Holditch-Davis, Diane; White-Traut, Rosemary; Levy, Janet et al. (2013) Maternal satisfaction with administering infant interventions in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs 42:641-54
White-Traut, Rosemary; Wink, Teresa; Minehart, Tali et al. (2012) Frequency of Premature Infant Engagement and Disengagement Behaviors During Two Maternally Administered Interventions. Newborn Infant Nurs Rev 12:124-131
Holditch-Davis, Diane; Levy, Janet (2010) Potential Pitfalls in Collecting and Analyzing Longitudinal Data from Chronically Ill Populations. Newborn Infant Nurs Rev 10:10-18