Adaptation and Acceptability of a Digitally Delivered Intervention for Parents of Very Low Birth Weight Infants

Abstract

Background Very low birth weight (VLBW) infants are at elevated risk for behavioral problems as early as the second year of life. The purpose of this feasibility study was to evaluate the adaptation and acceptability of an existing digitally delivered behavioral parent training program—the ezParent program, with the addition of weekly coaching calls—for parents of former VLBW infants in their second year of life. Objectives To assess the adaptation of ezParent for this population, we assessed parent access and use of ezParent and coaching calls, parent learning of strategies from ezParent, and changes in parenting practices or child behavior after using ezParent plus coaching calls. For acceptability, we assessed if parents viewed ezParent content as applicable to their experiences of parenting a former VLBW infant and how parents viewed coaching calls. Methods Ten parents of VLBW infants (20 months of age adjusted for prematurity) were recruited from a neonatal intensive care follow-up clinic. Parents completed the six modules of ezParent plus weekly coaching calls over 10-week intervention period. ezParent usage data were electronically uploaded to secure servers. Completion and timing of coaching calls were monitored using a tracking log. Parents completed child behavior and parenting belief and practice questionnaires pre- and postintervention. Calls were recorded and transcribed to assess for learning of parenting strategies, acceptability with the VLBW population, and acceptability of coaching calls. Results On average, parents completed 85% of the ezParent modules and 89% of the scheduled coaching calls, respectively. Parents spontaneously introduced 44% of the ezParent strategies during their coaching calls. Modest within-group effect sizes were detected for improvement in parenting self-efficacy and child externalizing behavior. Parents felt the ezParent content applied to their experiences parenting a preterm infant and had high satisfaction with coaching calls as a method of reinforcing program content and assessing knowledge and supporting accountability for program participation. Discussion ezParent with coaching calls is a feasible method of delivering behavioral parent training to parents of former VLBW infants in their second year of life. Coaching calls have high potential to be a low-cost, time-efficient component of digitally delivered programs that would allow for rapid integration into clinical practice.

ezPreemie study protocol: a randomised controlled factorial trial testing web-based parent training and coaching with parents of children born very preterm

“…Tips describe how parenting strategies can be modified to address neurodevelopmental delays common in VPT children. The tips are informed by findings from our feasibility study33 and literature of neurodevelopmental functioning, parental psychological distress and sensitive parenting in VPT children 40 41…”

“…Our previous research and the existing literature support the feasibility and efficacy of BPT and telephone coaching as individual treatment components for families of full-term children. [28][29][30][31][32][33] The Chicago Parent Programme (CPP) and its web-based application, the ezParent programme, is a BPT programme explicitly designed to be culturally responsive and sensitive for Black and Latinx families across a range of socioeconomic backgrounds and is effective in promoting prosocial child behaviour and improving parenting confidence and behaviour. 30 ezParent was designed to be self-directed to provide parent-controlled access as a feasible and potentially costeffective approach to address challenges in parent participation in face-to-face delivery.…”

Feasibility and acceptability of an online parenting intervention to address behaviour problems in moderately to extremely preterm pre‐school and school‐age children

“…Parenting interventions, specifically those targeting parent–child interaction patterns through the development of parenting skills such as differential attention, effective commands, and time‐out, have demonstrated high feasibility and acceptability (Luu, Xie, et al, 2017). Most parenting interventions for preterm children are targeted towards children ages 0–3 (Flierman et al, 2016; Greene et al, 2020; Rodríguez et al, 2014; Schappin et al, 2013). However, long‐term outcomes for early interventions suggest that effects may dissipate over time, with studies demonstrating no differences between the intervention and control group on behaviour problems at 1 (Schappin et al, 2013), 3 (Johnson et al, 2005) and 5 years following treatment (Johnson et al, 2005).…”

“…Most parenting interventions for preterm children are targeted towards children ages 0-3 (Flierman et al, 2016;Greene et al, 2020;Rodríguez et al, 2014;Schappin et al, 2013). However, long-term outcomes for early interventions suggest that effects may dissipate over time, with studies demonstrating no differences between the intervention and control group on behaviour problems at 1 (Schappin et al, 2013), 3 (Johnson et al, 2005) and 5 years following treatment (Johnson et al, 2005).…”

Growing and Glowing: A Digital Media Campaign to Increase Access to Pregnancy-Related Health Information for Black Women During the COVID-19 Pandemic

“…Various community-based programs reach Black women in Hillsborough County Florida (PGP: Growing and Glowing, n.d.). However, studies have also shown the potential to deliver pregnancy-related health information via digital sources, both prenatally and postnatally (Graham et al, 2019; Greene et al, 2020; Silfee et al, 2018). Further supporting the use of digital approaches, 40% of Black adults report getting health information online, and around 70% of Black adults use at least one social media platform (Lewis, 2017; Pew Research Center, 2019).…”