Implementation of an Evidence Based Parentally Administered Intervention for Preterm Infants

There are two cohorts of infants and parents: the Pre-H-HOPE Comparison Cohort and H-HOPE Cohort. H-HOPE is a family intervention, so parent(s) and infants are recruited together and must meet both parent and infant eligibility criteria. Infant and parent eligibility criteria are the same for both cohorts (Pre-H-HOPE and H-HOPE). Additionally, there are criteria for hospital personnel.

Inclusion criteria

for the infant:

• born between 23-35 weeks gestational age (GA)
• have reached 31-32 weeks post menstrual age (PMA)
• clinically stable
• male or female
• could be receiving oxygen or intravenous therapy
• could have been previously intubated for mechanical ventilation
• assessed as ready to begin social interaction Infants of multiple births will be eligible to participate but data from only one randomly selected infant will be used in analysis of Aim 2.

Inclusion criteria

for the parent (up to 2 per infant can be in the study:

• mother, father, other family member, or surrogate parent regardless of age, race/ethnicity, gender, or sexual orientation, or biological relationship to the infant
• intends to act in the role of parent
• 18 years of age or older
• English or Spanish speaking

Inclusion criteria

for hospital personnel:

Hospital Administrator - staff member with an administrative role outside of the NICU leadership who is knowledgeable about the activities of the NICU NICU Manager - Nurse or physician with an administrative role in the NICU (e.g. medical director or nurse manager) H-HOPE Team member - staff member who is part of the H-HOPE Team NICU Staff Nurse - registered nurse who provides direct patient care and works a minimum of 50% in the NICU Exclusion Criteria We will not be limiting any participants based on sex/gender, or ethnic/racial identity. Differences due to race and gender will be accounted for during data analysis. We will be limiting enrollment to English or Spanish speaking parents due to the limited availability of valid measures for data collection in languages other than English and Spanish. However, we anticipate that we will still be able to recruit an ethnically diverse group of parents because of the ethnic composition of the parents at the sites and our prior experience.

Exclusion criteria

for the infant:

• major brain injuries (e.g. cystic PVL)
• current sepsis
• intubated for mechanical ventilation at time of enrollment
• surgical necrotizing enterocolitis
• Ward of the State

Exclusion criteria

for the parent:

• positive drug screen for illegal substances
• planning to surrender custody of the infant or legal custody remove
• primary parent does not have legal guardianship of the infant
• Mental health diagnosis such as Psychosis, Bipolar Disease Exclusion Criteria Hospital Personnel
• None

Exclusion criteria

for NICU Staff Nurses:

• less than 50% effort.
• does not provide direct patient care