The purpose of this study is to test in a randomized clinical trial the effect of an intervention, Guided Caregiving Practice (GCP), designed to support families in caregiving for their very low birth weight (VLBW) infants. Ninety-eight families will be randomly assigned to either the GCP or standard care (SC) group. The study aim is to compare, at 12 and 24 months post-term age (PTA), the GCP group to the SC group on family caregiving competencies and on child feeding competencies and health and health-care outcomes. We hypothesize that the GCP group, compared to the SC group, will have: (1) mothers who are more competent in: (a) relating to their children, (b) providing sustaining and nurturing care, (c) communicating and problem-solving with others about the child's daily care, health, and health-care; and (d) regulating emotions; (2) children who have better health, as indexed by: (a) nutrition more adequate for needs in macronutrients (calories and protein) and in micronutrients (iron); (b) more adequate catch-up growth in weight and length; (c) higher scores on feeding competencies and on mental and motor development; and (d) fewer episodes of severe, acute illness; and (3) children whose cost of acute illness care is lower. The fourth hypothesis concerns the mechanism of the GCP: Mothers higher in caregiving competencies, accounting for infant biological conditions, personal resources, and family member and clinician support will have children with better health. """"""""
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