Intervention With African American Premature Infants

Abstract

This study evaluates the efficacy of an early intervention program targeting African American mothers and their premature, low birth weight infants at 3 to 4 months' corrected age from four neonatal intensive care units, 173 families are recruited (84 intervention, 89 control). The 8-session, 20-week intervention consists of a psychoeducational video, serial administrations of the Brazelton Neonatal Behavioral Assessment Scale, and maternally administered infant massage. At postintervention, intervention mothers have higher maternal self-efficacy than control. Extremely low birth weight (ELBW) intervention infants have significantly higher Bayley Mental Development Index (MDI) scores than ELBW control infants, but no intervention effects are observed among heavier preterm infants. Among infants of families living above federally established poverty thresholds, intervention infants have higher MDI scores than control infants. No intervention effects were found for infants of families living in poverty. Findings emphasize the importance of considering meaningful moderators in evaluations of early intervention effects.

Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis

“…Studies were from Australia [49,50]; England [51,52]; Germany [53]; Italy [54]; Japan [55]; Netherlands [56]; Norway [23]; and the United States [38,40,57-61]. See Table 1 for characteristics and methods of studies included in the review.…”

“…Four studies [38,39,54,55] included only singleton births. Five studies [40,57,58,60,61] included mother-infant pairs or dyads without mention of multiple gestations. In studies that reported allocation of multiple gestations [23,53], infants from one family were assigned to the same group.…”

“…Recruitment was problematic for three studies [50,55,58] with two studies [50,55] terminated without achieving the planned sample size. One program targeted an ethnically homogeneous population (i.e., African American; Teti, [61]); however, the majority of studies did not report ethnicity.…”

Preventive Interventions for Preterm Children

“…Moreover, for both high and low environmental risk samples, those families participating in the interventions were not only found to display higher levels of sensitive-responsiveness but also experienced less child-related stress and considered their children to be less challenging and temperamentally easier. 81–85 These findings were not consistent across studies but do allow the possibility that benefits to children may arise at later points in time. Although all these studies were based on the MITP, variations in the MITP protocols emphasized by different groups of investigators, sample differences, and the varied training levels and types of professionals implementing the interventions (e.g., nurses, occupational therapists, and physical therapists) make it difficult to find any meaningful patterns in the outcomes for combined NICU and home interventions.…”

“…78–81 Either no effects or minor effects on children’s cognitive development have been found, despite findings of improved parent sensitive-responsiveness. In fairness, however, children have not been followed for long periods of time.…”