A Feasibility Study of a Physical and Occupational Therapy-Led and Parent-Administered Program to Improve Parent Mental Health and Infant Development

Abstract

Aims

Extremely premature birth puts infants at high risk for developmental delay and results in parent anxiety and depression. The primary objective of this study was to characterize feasibility and acceptability of a therapist-led, parent-administered therapy and massage program designed to support parent mental health and infant development.

Methods

A single cohort of 25 dyads - parents (24 mothers, 1 father) and extremely preterm (<28 wk gestation) infants – participated in the intervention. During hospitalization, parents attended weekly hands-on education sessions with a primary therapist. Parents received bi-weekly developmental support emails for 12 months post-discharge and were scheduled for 2 outpatient follow up visits. We collected measures of parent anxiety, depression, and competence at baseline, hospital discharge, and <4 and 12 months post-discharge.

Results

All feasibility targets were met or exceeded at baseline and discharge (≥70%). Dyads participated in an average of 11 therapy sessions (range, 5–20) during hospitalization. Lower rates of data collection adherence were observed over successive follow ups (range, 40–76%). Parent-rated feasibility and acceptability scores were high at all time points.

Conclusions

Results support parent-rated feasibility and acceptability of the TEMPO intervention for extremely preterm infants and their parents in the Neonatal Intensive Care Unit.

Keywords:

• Family functioning
• high-risk newborn
• infant development
• mental health
• motor development
• premature
• service delivery

ClinicalTrials.gov ID:

• NCT04121897

Acknowledgments

The study team would like to thank the neonatal therapists, Kerry Blazek, Lauren Quinn, Sara Hammond, and Meredith Soucie, who provided the intervention for this study, and Erika Clary and Alana Gilbert for their research assistance in this project. The study team would also like to thank the parents and infants who enrolled in this study for sharing their time.

Data Availability Statement

Data available on request from the authors.

Disclosure Statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by the National Center for Complementary and Integrative Health under Grant 3KL2TR002490-02S1.

Notes on contributors

Dana B. McCarty

Dr. Dana B. McCarty, PT, DPT, PCS is an Assistant Professor of Physical Therapy in the School of Medicine at UNC Chapel Hill, the Director of UNC’s Pediatric Physical Therapy Residency, and Coordinator of UNC Health’s Neonatal Physical Therapy Fellowship. She is Board Certified Clinical Specialist in pediatric physical therapy and is a doctoral candidate at the UNC Gillings School of Global Public Health. Dr. McCarty’s research examines maternal and infant outcomes at the intersection of physical therapy intervention and public health contexts.

Stacey C. Dusing

Dr. Stacey C. Dusing, PT, PhD, FAPTA is an Associate Professor and the Sykes Family Chare in Pediatric Physical Therapy in the University of Southern California’s Division of Biokinesiology and Physical Therapy. She is a board certified Clinical Specialist in Pediatric Physical Therapy and the Director of the Motor Development Lab (MDL). Her primary research interests include understanding the influence of motor control on global development and efficacy of physical therapy interventions for infants.

Deborah Thorpe

Dr. Deborah Thorpe is a Professor Emerita of the Division of Physical Therapy, UNC School of Medicine whose research has focused on improving health care services function, and participation for adults with cerebral palsy. Dr. Thorpe was a primary mentor for the PI (McCarty) of the TEMPO study.

Morris Weinberger

Dr. Morris Weinberger, PhD is the Vergil N. Slee Distinguished Professor and Department Chair of Health Policy and Management at the UNC Gillings School of Public Health and served as the Co-PI for the UNC CTSA Education Program.

Susan Pusek

Dr. Susan Pusek, DrPH, MPH, MS is the Director of Education Programs for the NC Translational and Clinical Sciences Institute (NC TraCS) where she coordinates education, training, and career development related to clinical and translational research across the UNC campus and serves as the liaison for research collaborations among local institutions.

Alana Gilbert

Alana Gilbert, MPH received her Master of Public Health degree in Health Behavior from the UNC Gillings School of Global Public Health and currently serves as an Implementation Associate at the UNC Frank Porter Graham Child Development institute.

Tianyi Liu

Tianyi Liu is a PhD candidate in Biostatistics at UNC’s School of Global Public Health and serves as a statistical consultant for a broad range of scientific and non-scientific studies examining challenges within public health.

Kerry Blazek

Dr. Kerry Blazek, PT, DPT, PCS, CNT is a Board Certified Clinical Specialist in pediatric physical therapy and a certified neonatal therapist. She serves as the clinical lead for the pediatric acute physical therapy service line at UNC Health.

Sara Hammond

Sara Hammond, MSOT, OT/L, CNT, NTMTC is a certified neonatal therapist and is certified in neonatal touch and massage. She is an occupational therapist in the Newborn Critical Care Center at UNC Children’s Hospital.

T. Michael O’Shea

Dr. T. Michael O’Shea, MD, MPH, is the C. Richard Morris Distinguished Professor of Pediatrics at UNC. He is an experienced physician and researcher who specializes in neonatal and perinatal medicine with a particular interest in neurodevelopmental outcomes of very low gestational age newborns. He is the Principal Investigator for the 20+ year NIH-funded ELGAN-ECHO study and was the primary mentor for the PI (McCarty) of the TEMPO study.