An Internet-Based and Mobile Family Management Intervention for Mothers of Very Preterm Infants Hospitalized in the Neonatal Intensive Care Unit (the Preemie Progress Program): Pilot Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: Flexible approaches to parenting training interventions in the neonatal intensive care unit (NICU), including family integrated care (FICare) models, are urgently needed across the globe. Many FICare trials inadvertently exclude parents with low resources who cannot commit to daily infant care (eg, 4-8 hours/day). Preemie Progress (PP) is a fully automated, video-based training program that allows parents to choose when and where they learn, without requiring parent bedside presence. OBJECTIVE: This study aims to examine the feasibility of recruitment, retention, fidelity, and changes in outcomes during a pilot randomized controlled trial of PP, a video-based intervention aimed at training mothers of very preterm infants in evidence-based family management skills in the NICU. METHODS: Mothers of infants born between 25 weeks and 0 days to 31 weeks and 6 days of gestation were enrolled in an NICU in the Midwestern United States. Electronic surveys were sent to collect maternal outcomes (Patient-Reported Outcomes Measurement Information System [PROMIS] 8a depression and anxiety scales) at baseline (T1), 14 days (T2) and 28 days (T3) after T1, and 30 days after NICU discharge (T4). Infant electronic health records were extracted to collect infant (ie, weight gain velocity at 36 weeks and receipt of mother's milk) and health care outcomes (ie, NICU length of stay as well as readmissions and emergency department visits within 30 days of discharge). RESULTS: Of 123 eligible mothers, 64 (52%) were randomly assigned to 1 of 2 arms (PP: n=33, 52%; attention control [AC]: n=31, 48%). Loss to follow-up was 30% (10/33) in the PP arm and 13% (4/31) in the AC arm. PP mothers watched a mean 17.8 (SD 18.9) of 49 videos. PP retention was linked to higher fidelity. PP mothers showed trends toward greater reductions in anxiety 30 days after discharge (mean -7.54, SD 1.93; 95% CI -11.32 to -3.76) compared to AC mothers (mean -4.67, SD 1.59; 95% CI -7.80 to -1.55). PP infants trended toward greater receipt of exclusively mother's milk 28 days after baseline (PP: 14/26, 54%; AC: 10/28, 36%) and decreased NICU stay (PP: 57.2 days; AC: 68.3 days) but higher readmissions (PP: 4/33, 12%; AC: 2/31, 6%). CONCLUSIONS: We were able to recruit a diverse sample of mothers from a range of socioeconomic backgrounds, including mothers experiencing barriers to bedside presence. Recruitment goals were met. PP showed promising trends in improving maternal, infant, and health care outcomes. Additional studies are needed to optimize PP and study procedures to improve retention and fidelity. PP has the potential to support parent training outside of traditional FICare models or serve as a complement to structure the parent education pillar of adapted FICare models. TRIAL REGISTRATION: ClinicalTrials.gov NCT04638127; https://www.clinicaltrials.gov/study/NCT04638127.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».