Integrated Mother-Premature Infant Intervention and Mother-Infant Interaction At 6-Weeks Corrected Age
Title: Integrated Mother-Premature Infant Intervention and Mother-Infant Interaction At 6-Weeks Corrected Age
- Identify the components of the Ecological Model for early mother-premature infant intervention.
- Discuss the infant remediation and maternal re-education and redefinition components of the Integrated H-HOPE Intervention.
- Identify factors that contribute to improved patterns of mother-infant interaction following the H-HOPE Intervention.
Design: Prospective randomized clinical trial.
Setting: Two community hospital neonatal intensive care units.
Sample: Sample included (N=142) otherwise healthy infants, 29-34 weeks gestational age at birth, whose mothers reported at least 2 of 10 social-environmental risk factors, e.g., 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 (1) twice-daily infant stimulation using the ATVV (auditory, tactile, visual, and vestibular-rocking stimulation) and (2) four maternal participatory guidance sessions by a nurse-community member team. Mother-infant interaction was assessed at 6-weeks CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-minute play session). The Control and H-HOPE group were compared using: 1) Chi-square tests to assess the proportion with high DMC scores; and, 2) T-tests and multivariable linear regression to assess Overall NCAST, Maternal and Infant NCAST sub-scores.
Results: The H-HOPE group (n = 66) trended toward higher NCAST scores overall as well as the Social-Emotional Growth Fostering Subscale when compared with the Control group (n = 76). H-HOPE infants had significantly higher scores for the overall infant subscale (p = 0.05) and the Clarity of Cues Subscale. The H-HOPE dyads were also more likely to have high responsiveness per the DMC (67.6% versus 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 when compared to 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 both mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development.
Keywords: mother-infant interaction, synchronity, premature infants