Telehealth Delivery of the Homeostasis–Enrichment–Plasticity Approach for Premature Infants With Developmental Risks: Exploratory Feasibility Study (Preprint)
Bibliographic record
Abstract
BACKGROUND Preterm delivery is an increasing worldwide health concern linked to increased neurodevelopmental risks. Early intervention is crucial for harnessing neuroplasticity to enhance developmental and functional performance outcomes; however, access to early intervention is frequently hindered by logistical, financial, and labor constraints. The Homeostasis–Enrichment–Plasticity (HEP) Approach is a family-centered early intervention model based on enriched environments, designed to improve infants’ sensory-motor, cognitive, and socio-emotional development. OBJECTIVE This study aimed to assess the feasibility, safety, acceptability, and outcomes sensitivity to change of implementing the HEP Approach through telehealth for premature infants at developmental risk. METHODS A pre-post exploratory feasibility study was performed, including 16 preterm infants (aged 4-12 months corrected age), of whom 14 completed the study. The 12-week intervention included weekly remote sessions focused on environmental enrichment, active exploration, and parental guidance. The feasibility and acceptability were evaluated using a 24-item questionnaire. Developmental outcomes were assessed with the Young Children’s Participation and Environment Measure, Ages and Stages Questionnaire (ASQ), Alberta Infant Motor Scale, Infant Motor Profile, and Depression Anxiety Stress Scales. RESULTS High adherence (14/14, 100%) and retention (14/16, 87.5%) rates demonstrated robust feasibility. Parents indicated 86%-100% agreement across all feasible criteria, affirming safety, satisfaction, and acceptability. No adverse incidents were reported. Changes were identified in participation (Young Children’s Participation and Environment Measure), motor development (Alberta Infant Motor Scale, Infant Motor Profile, and ASQ), communication and social-emotional domains (ASQ), and caregiver well-being (Depression Anxiety Stress Scales) (P<.05). CONCLUSIONS The telehealth implementation of the HEP Approach demonstrated feasibility, safety, and strong acceptance among families, along with quantifiable developmental and psychosocial changes. These initial findings endorse the model’s viability as an accessible, family-oriented telehealth framework for infants born preterm. Future randomized controlled and longitudinal studies are necessary to validate intervention efficacy and scalability.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".