Integrated Mother–Premature Infant Intervention and Mother–Infant Interaction at 6‐Week Corrected Age

Abstract

Objective To examine whether an integrated intervention for mother–premature infant dyads relates to more positive mother–infant interaction at 6‐week corrected age (CA). Design Prospective randomized clinical trial. Setting Two community hospital neonatal intensive care units. Sample The sample included (N = 142) otherwise healthy infants, 29‐ to 34‐week gestational age at birth, whose mothers reported at least two of 10 social‐environmental risk factors, for example, poverty, minority status. Methods Mother–infant dyads were randomly assigned to a control group or the H‐HOPE group, which provided an integrated intervention that included twice‐daily infant stimulation using the auditory, tactile, visual, and vestibular rocking stimulation and four maternal participatory guidance sessions by a nurse‐community member team. Mother–infant interaction was assessed at 6‐week CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, six‐item contingency scale during a 5‐minute play session). The control and H‐HOPE groups were compared using chi‐square tests to assess the proportion with high DMC scores, and t‐tests and multivariable linear regression to assess Overall NCAST and Maternal and Infant NCAST subscores. Results The H‐HOPE group (n = 66) trended toward higher NCAST scores overall as well as the Social‐Emotional Growth Fostering Subscale than the control group (n = 76). H‐HOPE infants had significantly higher scores for the overall infant subscale (p = .05) and the Clarity of Cues Subscale. The H‐HOPE dyads were also more likely to have high responsiveness per the DMC (67.6% vs. 58.1% of controls). After adjustment for trait anxiety and infant morbidity scores, H‐HOPE dyads had marginally higher scores on overall mother–infant interaction during feeding than controls (β = 2.03, p = .06). Conclusion/Implications for Nursing Practice H‐HOPE infants presented clearer behavioral cues and had higher mutual responsiveness with their mothers during play. Intervening with mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development. To examine whether an integrated intervention for mother–premature infant dyads relates to more positive mother–infant interaction at 6‐week corrected age (CA). Prospective randomized clinical trial. Two community hospital neonatal intensive care units. The sample included (N = 142) otherwise healthy infants, 29‐ to 34‐week gestational age at birth, whose mothers reported at least two of 10 social‐environmental risk factors, for example, poverty, minority status. Mother–infant dyads were randomly assigned to a control group or the H‐HOPE group, which provided an integrated intervention that included twice‐daily infant stimulation using the auditory, tactile, visual, and vestibular rocking stimulation and four maternal participatory guidance sessions by a nurse‐community member team. Mother–infant interaction was assessed at 6‐week CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, six‐item contingency scale during a 5‐minute play session). The control and H‐HOPE groups were compared using chi‐square tests to assess the proportion with high DMC scores, and t‐tests and multivariable linear regression to assess Overall NCAST and Maternal and Infant NCAST subscores. The H‐HOPE group (n = 66) trended toward higher NCAST scores overall as well as the Social‐Emotional Growth Fostering Subscale than the control group (n = 76). H‐HOPE infants had significantly higher scores for the overall infant subscale (p = .05) and the Clarity of Cues Subscale. The H‐HOPE dyads were also more likely to have high responsiveness per the DMC (67.6% vs. 58.1% of controls). After adjustment for trait anxiety and infant morbidity scores, H‐HOPE dyads had marginally higher scores on overall mother–infant interaction during feeding than controls (β = 2.03, p = .06). H‐HOPE infants presented clearer behavioral cues and had higher mutual responsiveness with their mothers during play. Intervening with mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development.