Reduced Healthcare Utilization At 6-Week Corrected Age Among Premature Infants After the H-HOPE Mother–Infant Developmental Intervention

Authors


Paper Presentation

Objective

To examine whether an integrated developmental intervention for mothers and their premature infants results in lower levels of healthcare utilization (HCU) between hospital discharge and 6-week corrected age (CA).

Design

Prospective randomized clinical trial.

Setting

Two community hospital neonatal intensive care units.

Sample

Sample included (N = 145) otherwise healthy infants, 29- to 34-week gestational age at birth, whose mothers reported at least two of 10 social-environmental risk factors, for example, poverty, minority status.

Methods

The Impacts of Hospital-Home Transition: Optimizing Prematures’ Environment (H-HOPE) was tested. The intervention included infant remediation using a multisensory approach; and maternal redefinition and re-education using maternal participatory guidance. Maternal report of infant HCU after hospital discharge is measured at 6-week CA. t-Tests and multivariable log-binomial regression models (α = .05) were used to estimate the effect of the intervention on HCU.

Results

At 6-week CA, H-HOPE infants had a significantly lower number of healthcare visits than control infants (H-HOPE mean = 3.3, SD = 1.42, n = 68 vs. control mean = 3.8, SD = 1.41, n = 77). H-HOPE infants were significantly less likely to have visited a provider for an illness than control infants (30.9% vs. 46.8%, respectively). After controlling for maternal and infant factors, mothers in the H-HOPE group were 35% less likely to have taken their infants to one or more acute care visits by 6-week CA compared to control group mothers (adjusted prevalence ratio = 0.65, 95% CI 0.43-0.98, p = .04).

Conclusion/Implications for Nursing Practice

H-HOPE infants were less likely to see a provider for an illness between hospital discharge and 6-week CA. Costs of care for subsequent illness among preterm infants may be reduced as a result.

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