Comparison of family centered care with family integrated care and mobile technology (mFICare) on preterm infant and family outcomes: a multi-site quasi-experimental clinical trial protocol

Abstract

Background: Family Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes. Methods: This exploratory multi-site quasi-experimental study will compare usual FCC with mobile enhanced FICare (mFICare) on growth and clinical outcomes of preterm infants born at or before 33 weeks gestational age, as well as the stress, competence and self-efficacy of their parents. The feasibility and acceptability of using mobile technology to gather data about parent involvement in the care of preterm infants receiving FCC or mFICare as well as of the mFICare intervention will be evaluated (Aim 1). The effect sizes for infant growth (primary outcome) and for secondary infant and parent outcomes at NICU discharge and three months after discharge will be estimated (Aim 2). Discussion: This study will provide new data about the implementation of FICare in the US context within various hospital settings and identify important barriers, facilitators and key processes that may contribute to the effectiveness of FICare. It will also offer insights to clinicians on the feasibility of a new mobile application to support parent-focused research and promote integration of parents into the NICU care team in US hospital settings.

The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care

“…As new evidence‐based practices and interventions are brought forward, they can be integrated into the model. For example, technology may be implemented to further support parent education, peer support, and the communication and relationships between the clinical team and parents (Franck et al, ). Further research is needed to determine if the positive outcomes of FICare seen in countries with national healthcare systems can also be achieved in countries with predominantly private healthcare systems or in low and middle income countries.…”

“…Preliminary evidence suggests that a long‐term benefit to infants of the FICare model exists, with improvements seen in neurodevelopmental outcomes at 18 months postterm (Li et al, ). Research on the effectiveness of FICare in Level II NICUs and in the U.S. healthcare context is currently underway (Benzies et al, ; Franck et al, ).…”

Neonatal nursing during the COVID-19 global pandemic: A thematic analysis of personal reflections

“…Family engagement with increased participation in their baby's care has demonstrated increased breastfeeding rates, improved parental satisfaction, improved long-term infant neurodevelopment and reduced parental distress. Consequently, when family engagement is compromised and opportunities for parent-infant bonding are limited, the well-being of the baby and parents are negatively impacted ( Treyvaud et al, 2009 ; Rahkonen et al, 2014 ; Bastani et al, 2015 ; Al Maghaireh et al, 2016 ; Franck et al, 2019 ; O'Brien et al, 2018 ; Pineda et al, 2018 ; Yu et al, 2019 ; Pados and Hess, 2020 ).…”

Former NICU Families Describe Gaps in Family-Centered Care

“…Models of care that explicitly involve families are now considered best practice in the NICU and the implementation of family-centered care promotes mutual respect and shared decision-making between clinicians and families, ensuring timely and quality psychosocial supports and hospital resources that facilitate family well-being and involvement (Committee on Hospital Care and Institute for Patient- and Family-Centered Care, 2012; Franck & O’Brien, 2019). Family-centered care also includes direct care delivered by families to their infants, which is associated with better infant and parent outcomes and improved quality of care (Charpak et al, 2017; Franck et al, 2019; Patra et al, 2017). Despite expressed commitment to family-centered care, hospital systems and NICUs inconsistently and incompletely support the integration of family members as partners in infant caregiving and decision-making.…”