An mHealth Intervention to Support Psychosocial Well-Being of Racial and Ethnically Diverse Families in the Neonatal Intensive Care Unit

Abstract

Objective

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.

Study design

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.

Results

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.

Conclusions

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.