Garfield Craig F, Santiago Joshua E, Jackson Kathryn L, Patra Kousiki, Loughead Jeffrey L, Fisher Joel B, O'Sullivan Kathleen, Christie Rebecca, Lee Young S
Ann and Robert H. Lurie Children's Hospital of Chicago, Family and Child Heath Innovations Program, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL.
Northwestern University Feinberg School of Medicine, Chicago, IL.
J Pediatr. 2025 May;280:114470. doi: 10.1016/j.jpeds.2025.114470. Epub 2025 Jan 27.
To assess the effectiveness of an mHealth neonatal intensive care unit (NICU) parent support smartphone application to improve psychosocial well-being, specifically reduced stress and anxiety, increased parenting competence, and improved social support among a diverse group of parents with infants born preterm in 3 Chicago-area NICUs.
A time-lapsed, quasiexperimental design in which control participants were enrolled and then intervention participants enrolled. Data collection occurred at 3 timepoints: NICU admission (AD), discharge (DC), and 30 days post-DC (DC+30). Validated outcome measures included parenting sense of competence, stress, anxiety, and social support.
Intention-to-treat analyses included 400 participants (156 intervention; 244 control). After covariate adjustment, a significant increase in parenting sense of competence (AD-DC, DC+30), decrease in stress (AD-DC+30), decrease in anxiety (AD-DC, DC+30), and increase in social support (AD-DC) were noted but did not differ by study arm. However, secondary analysis of parents with infants born at <32 weeks of gestational age (156 participants) showed decrease in stress (AD-DC+30) that was greater in intervention vs control group (P = .03). Among intervention participants who were Black, a significant increase in social support (AD-DC) total score (P = .01), and 2 subscales of emotional/informational support (P = .02) and positive social interaction (P = .02) were found.
This novel mHealth intervention shows evidence of reduced stress and anxiety while increasing social support among some subsets of parents at high risk of negative psychosocial experiences in the NICU, potentially enhancing outcomes for infants born preterm by ensuring that parents are less stressed and better supported.
评估一款移动健康新生儿重症监护病房（NICU）家长支持智能手机应用程序的有效性，该程序旨在改善心理社会幸福感，具体包括减轻压力和焦虑、提高育儿能力以及增强芝加哥地区3家新生儿重症监护病房中不同背景的早产婴儿家长的社会支持。
采用时间推移的准实验设计，先招募对照组参与者，然后招募干预组参与者。在3个时间点进行数据收集：NICU入院时（AD）、出院时（DC）以及出院后30天（DC+30）。经过验证的结局指标包括育儿能力感、压力、焦虑和社会支持。
意向性分析纳入了400名参与者（156名干预组；244名对照组）。在进行协变量调整后，发现育儿能力感显著增加（AD-DC，DC+30），压力降低（AD-DC+30），焦虑降低（AD-DC，DC+30），社会支持增加（AD-DC），但两组之间无差异。然而，对孕周小于32周的婴儿家长进行的二次分析（156名参与者）显示，干预组的压力降低幅度（AD-DC+30）大于对照组（P = 0. = 03）。在黑人干预组参与者中，发现社会支持总分（AD-DC）显著增加（P = 0.01），情感/信息支持和积极社会互动这两个子量表也显著增加（P = 0.02）。
这项新颖的移动健康干预措施显示出有证据表明，在NICU中面临负面心理社会经历高风险的部分家长亚组中，压力和焦虑有所减轻，同时社会支持有所增加，这可能通过确保家长压力更小且得到更好的支持来改善早产婴儿的结局。
