PREEMIE PROGRESS 3.0: A family management program for parents of preterm infants - Abstract The purpose of this proposal is to holistically meet parents of very preterm infants' urgent need for a comprehensive intervention that teaches complex infant care, offers psychosocial support, and provides resources to address the Social Determinants of Health (SDOH). Over 100,000 U.S. parents give birth annually to very preterm infants (<32 weeks gestation), who require Neonatal Intensive Care Unit (NICU) admission at a cost of $6 billion. Families affected by very preterm birth endure months of NICU hospitalization, significant infant comorbidities, and frequent readmissions after NICU discharge. In the United States, parents receive limited structured training, psychosocial support, and SDOH resources to manage complex infant care in partnership with the NICU team. Inadequate care and support of the NICU parent impedes parenting efficacy and fuels parent withdrawal, ultimately increasing rates of maternal mental health complications, abnormal infant development, prolonged NICU stay, and increased post-discharge care utilization. These poor maternal-infant outcomes are seen at even greater rates in families of low economic status, who disproportionately bear the burdens of very preterm birth. PREEMIE PROGRESS (PP) is a comprehensive program that provides flexible infant care training, psychosocial support, and SDOH resources to NICU parents. PP trains parents in evidence-based family management skills (e.g., meeting infant healthcare needs, activating resources, daily living with prematurity), so parents can effectively manage their infant's NICU care. PP also provides psychosocial support (e.g., peer mentors, support groups, etc.) and SDOH resources so parents sustain their role on the NICU team. The purpose of this R21 proposal is to personalize and then pilot test PP in a pilot randomized controlled trial. First, we will personalize PP during iterative usability testing of a comprehensive maternal needs assessment that tailors PP programming to each family's unique needs. Then, we will examine feasibility of the personalized PP and revised study procedures with a pilot randomized controlled trial enrolling 60 mothers and their very preterm infants in the NICU. This proposal will significantly advance maternal-infant health with an innovative, personalized program that holistically addresses NICU parent training, psychosocial support, and SDOH needs.
