Journal article
Promoting Equity in Parent Presence and Participation in Neonatal Intensive Care: Protocol for a Prospective Cohort Study
JMIR research protocols, Vol.14, e71930
08/27/2025
DOI: 10.2196/71930
PMCID: PMC12423611
PMID: 40864498
Abstract
Parents of infants born preterm experience many barriers to their presence in the neonatal intensive care unit (NICU) and participation in infant caregiving. Parents from historically marginalized backgrounds or with limited social or economic resources may experience even more profound barriers, creating a significant source of health inequity for these parents and their infants. While the specific barriers and facilitators of parent presence and participation (PPP) in caregiving are unknown, PPP may be critical for improving clinical outcomes and neurodevelopment for infants born preterm.
This study aims to (1) longitudinally determine the barriers and facilitators affecting PPP specific to parents with diverse sociodemographic characteristics, (2) determine the effect of PPP on infant clinical outcomes and neurodevelopment and the potential mediating effect of parent-infant responsiveness, and (3) determine the moderation effect of PPP on the relationship between infant stress exposure and infant clinical outcomes and neurodevelopment. We hypothesize that barriers and facilitators of PPP will vary based on sociodemographic characteristics and will change over the duration of a NICU hospitalization. We expect that higher levels of PPP will be associated with better infant outcomes.
Parents (N=375) of infants born preterm, at <32 weeks' gestational age, will be enrolled in a prospective cohort study. The parents will complete a daily survey documenting the amount of time spent in the NICU and the caregiving activities performed. The parents will also complete surveys at regular intervals during their infant's admission to report barriers and facilitators of PPP, NICU-related stress, depressive symptoms, experiences of discrimination, and engagement with NICU staff. Additional data will be collected throughout each infant's hospitalization, including invasive procedures, infant clinical data, and nursing documentation of PPP. The parents will complete the maternal-infant responsiveness instrument at the time of NICU discharge and at 3 months' corrected age (CA). Infant clinical outcomes include the achievement of feeding milestones and the length of NICU stay. The infants will be assessed at 3 months' CA using the test of infant motor performance and at 12 months' CA using the Bayley scales of infant and toddler development, fourth edition.
Funding was awarded in August 2024. Data collection and analysis are expected to be completed by July 2029.
By identifying the important barriers and facilitators of PPP over the duration of hospitalizations of infants born preterm and differences in these factors based on sociodemographic characteristics, time- and population-targeted interventions can be developed to remove system-level barriers and enhance facilitators. These efforts may increase PPP and promote health equity for diverse families.
PRR1-10.2196/71930.
Details
- Title: Subtitle
- Promoting Equity in Parent Presence and Participation in Neonatal Intensive Care: Protocol for a Prospective Cohort Study
- Creators
- Marliese Dion Nist - The Ohio State UniversityAbigail B Shoben - The Ohio State UniversityLeif D Nelin - The Ohio State UniversityLisa S Segre - University of IowaRita H Pickler - The Ohio State University
- Resource Type
- Journal article
- Publication Details
- JMIR research protocols, Vol.14, e71930
- DOI
- 10.2196/71930
- PMID
- 40864498
- PMCID
- PMC12423611
- NLM abbreviation
- JMIR Res Protoc
- ISSN
- 1929-0748
- eISSN
- 1929-0748
- Publisher
- JMIR PUBLICATIONS, INC
- Grant note
- National Institute of Child Health and Human Development of the National Institutes of Health: R01HD113525 Clinical and Translational Science Institute at The Ohio State University: UM1TR004548
Funding for this work is provided by the National Institute of Child Health and Human Development of the National Institutes of Health under award number R01HD113525 (multiple principal investigators: MDN and RHP) . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Study data will be collected and managed using REDCap electronic data capture tools hosted at The Ohio State University, funded through an award to the Clinical and Translational Science Institute at The Ohio State University (UM1TR004548) .
- Language
- English
- Date published
- 08/27/2025
- Academic Unit
- Nursing
- Record Identifier
- 9984958288802771
Metrics
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